Donor cell myelodysplastic syndrome after allogeneic stem cell transplantation responding to donor lymphocyte infusion: case report and literature review.
Allogeneic hematopoietic stem cell transplantation (SCT) is a potentially curative treatment for patients with myelodysplastic syndrome (MDS). Relapses after transplantation however, are not uncommon and are usually due to re-emergence of a recipient derived, neoplastic, stem cell clone. We report a unique case of MDS recurring 5 months after non-myeloablative, sibling, allogeneic SCT. Interestingly, chimerism analysis at relapse showed hematopoiesis to be entirely of donor origin confirming donor cell MDS. Donor lymphocyte infusion (DLI) produced a hematological response lasting several months. Our review of the literature shows donor-derived MDS to be very rare, with only four such cases described previously. In this report, we describe the details of our case and discuss putative mechanisms underlying the genesis of donor cell MDS and the observed response to DLI.
Department of Medicine, University of Rochester School of Medicine and Dentistry and James P. Wilmot Cancer Center, Rochester, New York 14642, USA. rami_komrokji@urmc.rochester.edu
Rami
R
Komrokji
Jainulabdeen J
JJ
Ifthikharuddin
Raymond E
RE
Felgar
Camille N
CN
Abboud
Lucy A
LA
Wedow
Anna
A
Connaughton
John M
JM
Bennett
D000753:Anemia, Refractory / Q000209:etiology* / Q000628:therapy / Q000821:virology; D000754:Anemia, Refractory, with Excess of Blasts / Q000188:drug therapy / Q000628:therapy*; D001853:Bone Marrow / Q000821:virology; D003587:Cytomegalovirus / Q000302:isolation & purification / Q000472:pathogenicity; D003586:Cytomegalovirus Infections / Q000150:complications; D020031:Epstein-Barr Virus Infections / Q000150:complications; D006085:Graft Survival; D004854:Herpesvirus 4, Human / Q000302:isolation & purification / Q000472:pathogenicity; D006648:Histocompatibility; D006801:Humans; D017710:Lymphocyte Transfusion; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D012008:Recurrence; D018183:Transplantation Chimera; D014184:Transplantation, Homologous; D014766:Viremia / Q000150:complications