Leukaemic relapse of donor origin after allogeneic bone marrow transplantation from a donor who later developed bronchogenic carcinoma.
Donor-derived leukaemia is exceptional after allogeneic bone marrow transplantation (BMT). A woman with chronic myeloid leukaemia received an allogeneic BMT from a human leucocyte antigen-identical brother. The donor, a 50-year-old non-smoker, died of squamous cell bronchogenic carcinoma 1 year later. At 4 years post BMT, the patient became BCR/ABL positive and relapsed with acute myeloid leukaemia, which was shown to be donor-derived cytogenetically and molecularly. Retrospective analysis showed that the donor-leukaemic clone had started to evolve as early as 6 months post BMT. Sequencing of p53 ruled out Li-Fraumeni syndrome. Predisposition to malignancy might be an underlying mechanism of donor-cell leukaemia.
Au
W Y
WY
Department of Medicine, Queen Mary Hospital, Hong Kong.
Chan
E C
EC
Siu
L L P
LL
Lau
T C M
TC
Lie
A K W
AK
Ma
S K
SK
Kwong
Y L
YL
D000208:Acute Disease; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002283:Carcinoma, Bronchogenic / Q000150:complications; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy; D007951:Leukemia, Myeloid / Q000209:etiology* / Q000235:genetics; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D012008:Recurrence; D012907:Smoking / Q000009:adverse effects; D014019:Tissue Donors; D014184:Transplantation, Homologous