title: Donor cell leukemia after allogeneic peripheral blood stem cell transplantation: a case report and literature review.
abstract: A 49-year-old male developed recurrent acute myeloid leukemia 27 months after allogeneic peripheral blood stem cell transplantation (PBSCT) from an HLA-identical brother. The immunophenotype of the blastic cell population was incompatible with that of the pre-transplant blast cells; a mutation in C/EBPA gene was found in the pre-transplant blast cells that was not present in the post-transplant blast cells, and short tandem repeat analysis of marrow cells, which included 71% blasts, showed complete donor chimera. Thus, this recipient developed donor cell leukemia (DCL). The donor was healthy when DCL developed in the recipient as well as before donation of the peripheral blood stem cells. Only five cases of DCL after PBSCT have been reported in the literature. As a mechanism for the development of DCL, a vigorous proliferative demand on the donor cells, which often correlates with a higher likelihood of replication error or mutation, has been proposed. Peripheral blood stem cells might have an advantage in that they are associated with a low incidence of DCL development because PBSCT recipients receive a higher total cell dose than recipients of bone marrow or cord blood cells.
authors.affiliation: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan. mmurata@med.nagoya-u.ac.jp.
authors.forename: Makoto
authors.initials: M
authors.lastname: Murata
authors.affiliation: Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishikawa
authors.affiliation: Clinical Research Center, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Ohashi
authors.affiliation: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
authors.forename: Seitaro
authors.initials: S
authors.lastname: Terakura
authors.affiliation: Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Ozeki
authors.affiliation: Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kiyoi
authors.affiliation: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Naoe
mesh_terms: D022763:CCAAT-Enhancer-Binding Protein-alpha / Q000235:genetics; D006801:Humans; D015470:Leukemia, Myeloid, Acute; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009154:Mutation; D036102:Peripheral Blood Stem Cell Transplantation; D014184:Transplantation, Homologous
chemical_list: D022763:CCAAT-Enhancer-Binding Protein-alpha