title: Donor cell-derived acute lymphocytic leukemia after allogeneic stem cell transplantation for multiple myeloma.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuou-ku, Niigata, Niigata, 951-8566, Japan. igarashi@niigata-cc.jp.
authors.forename: Natsue
authors.initials: N
authors.lastname: Igarashi
authors.affiliation: Department of Internal Medicine, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuou-ku, Niigata, Niigata, 951-8566, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Chou
authors.affiliation: Department of Internal Medicine, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuou-ku, Niigata, Niigata, 951-8566, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hirose
authors.affiliation: Department of Internal Medicine, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuou-ku, Niigata, Niigata, 951-8566, Japan.
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Imai
authors.affiliation: Department of Internal Medicine, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuou-ku, Niigata, Niigata, 951-8566, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Ishiguro
authors.affiliation: Department of Pathology, Niigata Cancer Center Hospital, Niigata, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Nemoto
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib; D003907:Dexamethasone
references.citation: Haematologica. 2008 Mar;93(3):455-8
references.pmid: 18287132
references.citation: Leukemia. 2006 Apr;20(4):744-5
references.pmid: 16437136
references.citation: Haematologica. 2005 Jul;90(7):969-75
references.pmid: 15996934
references.citation: J Pediatr Hematol Oncol. 2006 Nov;28(11):763-7
references.pmid: 17114967
references.citation: Bone Marrow Transplant. 2008 Jan;41(1):91-2
references.pmid: 17982506
references.citation: Biol Blood Marrow Transplant. 2006 May;12(5):511-7
references.pmid: 16635786
references.citation: Bone Marrow Transplant. 2000 Jun;25(11):1209-11
references.pmid: 10849535
references.citation: Blood. 2005 Dec 15;106(13):4377-80
references.pmid: 16118319
references.citation: Blood. 2007 Apr 1;109(7):2688-92
references.pmid: 17132724
references.citation: Int J Hematol. 2007 Aug;86(2):192-5
references.pmid: 17875537
references.citation: Am J Hematol. 2006 May;81(5):370-3
references.pmid: 16628734
references.citation: Int J Hematol. 2008 Jul;88(1):111-115
references.pmid: 18470599
references.citation: Am J Hematol. 2005 Aug;79(4):294-8
references.pmid: 16044441
references.citation: Am J Hematol. 2000 Jan;63(1):46-53
references.pmid: 10602169
references.citation: Am J Hematol. 2006 Mar;81(3):178-85
references.pmid: 16493618
references.citation: Acta Clin Belg. 2006 Mar-Apr;61(2):82-6
references.pmid: 16792340
references.citation: Haematologica. 2007 Sep;92(9):1295-6
references.pmid: 17768136