Donor cell-derived leukemias/myelodysplastic neoplasms in allogeneic hematopoietic stem cell transplant recipients: a clinicopathologic study of 10 cases and a comprehensive review of the literature.

Journal Article (Journal Article;Review)

We report 10 cases of donor cell leukemia (DCL). All cases except the case of chronic lymphocytic leukemia had anemia, neutropenia, and/or thrombocytopenia when DCL was diagnosed. Eight cases with sex-mismatched hematopoietic stem cell transplant (HCT) showed donor gonosomal complements, suggesting DCL. Clonal cytogenetic abnormalities were detected in 8 cases: 6 were monosomy 7/del(7q). In all 10 cases, engraftment studies confirmed donor cell origin. Retrospective fluorescence in situ hybridization in archived donor cells in 4 cases showed a low level of abnormalities in 2. Of 7 patients with clinical follow-up of 5 months or more, 1 (with acute myeloid leukemia) died of disease; 6 are alive, including 1 with myelodysplastic syndrome with spontaneous remission. Similar to reported cases, we found disproportional sex-mismatched HCTs, suggesting probable underdetection of DCL in sex-matched HCTs. The latency between HCT and DCL ranged from 1 to 193 months (median, 24 months), in keeping with the literature. Analyzing our cases, pooled with reported cases, with survival models showed much shorter latency for malignancy as primary disease, for T-cell large granular lymphocyte leukemia as type of DCL, and for umbilical cord blood as stem cell source.

Full Text

Duke Authors

Cited Authors

  • Wang, E; Hutchinson, CB; Huang, Q; Lu, CM; Crow, J; Wang, FF; Sebastian, S; Rehder, C; Lagoo, A; Horwitz, M; Rizzieri, D; Yu, J; Goodman, B; Datto, M; Buckley, P

Published Date

  • April 2011

Published In

Volume / Issue

  • 135 / 4

Start / End Page

  • 525 - 540

PubMed ID

  • 21411775

Electronic International Standard Serial Number (EISSN)

  • 1943-7722

Digital Object Identifier (DOI)

  • 10.1309/AJCPPJUQ9DNR1GHP

Language

  • eng

Conference Location

  • England