Myelodysplastic syndrome of donor origin subsequent to successful treatment of myeloid/NK-cell precursor leukaemia with allogeneic PBSCT: two very rare conditions in one patient.
We report a 36-year-old male with myeloid/natural killer (NK)-cell precursor acute leukaemia with a complex aberrant karyotype, who was treated according to an acute-myeloid-leukaemia (AML) treatment protocol (idarubicine, cytarabine, and etoposide) followed by high-dose cytarabine consolidation and achieved complete remission. He underwent allogeneic matched unrelated donor (MUD) peripheral blood stem-cell transplantation (PBSCT) and remained in remission throughout his remaining life. Seven months posttransplantation, a myelodysplastic syndrome (MDS) with (20q-) of donor origin was diagnosed causing severe thrombocytopenia and finally leading to infection and death. This patient represents one of the few cases published achieving remission for a significant period of time after being diagnosed with myeloid/NK-cell precursor acute leukaemia, a very rare malignant disease. We conclude, despite the fatal outcome due to infection, that allogeneic PBSCT is a therapeutic option for patients with this entity. In addition, the development of a myelodysplastic syndrome of donor origin is extremely rare and only very few cases are published worldwide.
Beck
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Humpe
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Harder
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Schmid
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Horst
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HA
D000208:Acute Disease; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018572:Disease-Free Survival; D017809:Fatal Outcome; D006801:Humans; D007239:Infections; D007694:Killer Cells, Natural / Q000473:pathology*; D007951:Leukemia, Myeloid / Q000473:pathology* / Q000628:therapy*; D015461:Leukemia, Prolymphocytic, T-Cell / Q000473:pathology* / Q000628:therapy; D008297:Male; D009190:Myelodysplastic Syndromes / Q000209:etiology*; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D012074:Remission Induction / Q000379:methods; D013921:Thrombocytopenia; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome