The spectrum of myelodysplastic syndromes post-solid organ transplantation: a single institutional experience.
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.
Menes
M
M
Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Vakiani
E
E
Keller
C E
CE
Ho
E K
EK
Colovai
A
A
Nichols
G
G
Diuguid
D
D
Mears
J G
JG
Murty
V V
VV
Alobeid
B
B
Bhagat
G
G
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