title: The spectrum of myelodysplastic syndromes post-solid organ transplantation: a single institutional experience.
abstract: An increased incidence of acute myeloid leukemia (AML) has recently been documented in patients post-solid organ transplantation but the incidence and types of myelodysplastic syndromes (MDS) occurring in this patient population are not known. We identified 5 patients (3M, 2F, age 48-64 years) who developed MDS ranging from 1.8 to 25 years (median 4.2 years) post-solid organ transplantation, only 2 patients had received azathioprine. The cumulative incidence of MDS in heart and lung transplant recipients at 15 years was 0.5% and 1.8%, respectively, which is markedly higher compared to the general population. Low-risk types of MDS predominated, 3 of 5 patients are alive (median 3.9 years) since diagnosis. Deletions of chromosome 20q, which have not been previously reported in post-transplant MDS/AML, were identified in 3 cases. Our findings expand the morphologic and cytogenetic spectrum of MDS occurring post-solid organ transplantation and suggest that mechanisms beside azathioprine toxicity might be important in disease pathogenesis.
authors.affiliation: Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
authors.forename: M
authors.initials: M
authors.lastname: Menes
authors.forename: E
authors.initials: E
authors.lastname: Vakiani
authors.forename: C E
authors.initials: CE
authors.lastname: Keller
authors.forename: E K
authors.initials: EK
authors.lastname: Ho
authors.forename: A
authors.initials: A
authors.lastname: Colovai
authors.forename: G
authors.initials: G
authors.lastname: Nichols
authors.forename: D
authors.initials: D
authors.lastname: Diuguid
authors.forename: J G
authors.initials: JG
authors.lastname: Mears
authors.forename: V V
authors.initials: VV
authors.lastname: Murty
authors.forename: B
authors.initials: B
authors.lastname: Alobeid
authors.forename: G
authors.initials: G
authors.lastname: Bhagat
mesh_terms: D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D007951:Leukemia, Myeloid / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000145:classification* / Q000453:epidemiology* / Q000473:pathology; D016377:Organ Transplantation / Q000009:adverse effects* / Q000145:classification; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies