Donor cell-derived acute lymphocytic leukemia after allogeneic stem cell transplantation for multiple myeloma.
Donor cell leukemia (DCL) is a rare, but well-known, complication after allogeneic hematopoietic cell transplantation. We report a case of donor cell-derived acute lymphocytic leukemia (ALL) occurring in a 55-year-old man after allogeneic bone marrow transplantation (allo-BMT) from an HLA-matched unrelated donor for refractory multiple myeloma (MM). Molecular analysis using short tandem repeat sequences proved the ALL to be of donor origin. He underwent combination chemotherapy and second allo-BMT from an alternative donor. After second allo-BMT, extramedullary myeloma relapsed as tumor, but was successfully treated with proteasome inhibitor, bortezomib. However, he died from severe graft-versus-host disease four months after the second transplantation. Although more than 50 cases of DCL have been reported, there have been only two reports of DCL developed in MM patients including our case. This rare complication may give some insights into leukemogenesis.
Igarashi
Natsue
N
Department of Internal Medicine, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuou-ku, Niigata, Niigata, 951-8566, Japan. igarashi@niigata-cc.jp.
Chou
Takaaki
T
Department of Internal Medicine, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuou-ku, Niigata, Niigata, 951-8566, Japan.
Hirose
Takayuki
T
Department of Internal Medicine, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuou-ku, Niigata, Niigata, 951-8566, Japan.
Imai
Yousuke
Y
Department of Internal Medicine, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuou-ku, Niigata, Niigata, 951-8566, Japan.
Ishiguro
Takuro
T
Department of Internal Medicine, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuou-ku, Niigata, Niigata, 951-8566, Japan.
Nemoto
Keiichi
K
Department of Pathology, Niigata Cancer Center Hospital, Niigata, Japan.
D000970:Antineoplastic Agents / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D001897:Boronic Acids / Q000627:therapeutic use; D000069286:Bortezomib; D003907:Dexamethasone / Q000627:therapeutic use; D017809:Fatal Outcome; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000209:etiology*; D011719:Pyrazines / Q000627:therapeutic use; D014019:Tissue Donors; D014184:Transplantation, Homologous
D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib; D003907:Dexamethasone
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