title: Increased incidence of acute myeloid leukemia after liver transplantation? Description of three new cases and review of the literature.
abstract: BACKGROUND
  Acute myeloid leukemia (AML) after solid organ transplantation is rare, with only six AML cases after liver transplantation (LT) being reported.
  
  
  METHODS
  Characteristics of three AML cases observed among 799 recipients of LT in the authors' institution and estimation of the standardized incidence ratio (SIR) are presented.
  
  
  RESULTS
  Three AML cases were diagnosed (French-American-British classification subtypes M0, M3, and M1) at 38 days, 2 years, and 3.5 years after LT, respectively. The immunosuppressive regimen consisted of cyclosporine A and prednisone. The recipient's origin of blasts could be demonstrated in two cases. All patients achieved complete remission after standard treatment. Nonetheless, disease relapsed in two patients at 2 and 6 months, whereas the patient with acute promyelocytic leukemia remains disease-free 4 years after diagnosis. As compared with the general population, the observed incidence of AML in the authors' series of LT results in a significantly higher SIR of 11.41 (P=0.0023).
  
  
  CONCLUSIONS
  The higher SIR found in the authors' series suggests an increased risk of AML in patients undergoing LT.
authors.affiliation: Department of Hematology, Hemopathology Unit, Institute of Hematology and Oncology, Hospital Clínic, Barcelona, Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Camós
authors.forename: Jordi
authors.initials: J
authors.lastname: Esteve
authors.forename: Antoni
authors.initials: A
authors.lastname: Rimola
authors.forename: Luis
authors.initials: L
authors.lastname: Grande
authors.forename: María
authors.initials: M
authors.lastname: Rozman
authors.forename: Dolors
authors.initials: D
authors.lastname: Colomer
authors.forename: Neus
authors.initials: N
authors.lastname: Villamor
authors.forename: Dolors
authors.initials: D
authors.lastname: Costa
authors.forename: Emili
authors.initials: E
authors.lastname: Montserrat
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000453:epidemiology*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors