Donor cell leukemia after allogeneic peripheral blood stem cell transplantation: a case report and literature review.
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.
Murata
Makoto
M
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.
Ishikawa
Yuichi
Y
Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Ohashi
Haruhiko
H
Clinical Research Center, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan.
Terakura
Seitaro
S
Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
Ozeki
Kazutaka
K
Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Kiyoi
Hitoshi
H
Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Naoe
Tomoki
T
Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
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
D022763:CCAAT-Enhancer-Binding Protein-alpha