title: Transient donor cell-derived myelodysplastic syndrome with monosomy 7 after unrelated cord blood transplantation.
abstract: Donor cell leukaemia or myelodysplastic syndromes are extremely rare complications that have been observed not only after haematopoietic transplantation with progenitor cells harvested from bone marrow and peripheral blood, but also after cord blood transplantation. We describe the early onset of monosomy 7 in donor cells after cord blood transplantation in a patient diagnosed with myelodysplastic syndrome 3 months after transplantation. Fluorescent in situ hybridisation analysis performed in a cryopreserved aliquot of the cord blood showed 2.5% of nuclei with monosomy 7. The cord blood donor was studied and he showed neither peripheral blood cytopenias nor cytological or cytogenetic features of myelodysplasia. The cell blood counts (CBC) of the girl have improved over 2 yr while decreasing the percentage of monosomic cells. The monosomic clone has finally disappeared and the CBC are finally normal. This case of transient monosomy 7 started very early after engraftment emphasises the relevance of clonal instability of specific progenitor cells in the early engraftment, and host immune status, in cytogenetic abnormalities founded in donor cell-derived MDS and acute leukaemia. Moreover, the clinical follow-up of this patient, recommends a more conservative treatment for this clonal disease early developed after transplantation.
authors.affiliation: Oncohematología pediátrica Hospital Universitario Niño Jesús, Madrid, Spain. jsevilla.hnjs@salud.madrid.org
authors.forename: Julián
authors.initials: J
authors.lastname: Sevilla
authors.forename: Sergio
authors.initials: S
authors.lastname: Querol
authors.forename: Antonio
authors.initials: A
authors.lastname: Molines
authors.forename: Marta
authors.initials: M
authors.lastname: González-Vicent
authors.forename: Antonio
authors.initials: A
authors.lastname: Balas
authors.forename: Ana
authors.initials: A
authors.lastname: Carrió
authors.forename: Jesús
authors.initials: J
authors.lastname: Estella
authors.forename: Miguel
authors.initials: M
authors.lastname: Angel Díaz
authors.forename: Luis
authors.initials: L
authors.lastname: Madero
mesh_terms: D002675:Child, Preschool; D002897:Chromosomes, Human, Pair 7 / Q000235:genetics*; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D009006:Monosomy; D009190:Myelodysplastic Syndromes / Q000209:etiology* / Q000235:genetics*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy; D013997:Time Factors; D014019:Tissue Donors