title: Donor cell origin of multiple myeloma occurring after allogeneic haematopoietic stem cell transplantation in a patient with refractory anaemia with ring sideroblast.
abstract: Post-transplant lymphoproliferative disorder (PTLD) is a rare but life-threatening complication after solid organ and haematopoietic stem cell transplantation. A 40-year-old woman who was diagnosed as having refractory anaemia with ring sideroblast 6 years ago took an ABO mismatched, unrelated allogeneic haematopoietic stem cell transplantation (HSCT) from a 32-year-old healthy male donor. The bone marrow (BM) study was carried out because of progressing pancytopenia, serum biclonal gammopathy and a distorted ratio of serum level of free κ and λ light chain 138 days after HSCT. The BM examination showed an increased number of plasma cells (12% of total marrow cells) comprising mainly CD45-CD19-CD138+ malignant plasma cells with an immunoglobulin heavy-chain gene rearrangement. Conventional cytogenetics and molecular personal identification studies revealed that all BM cells were totally replaced by donor cells, thus indicating the donor cell origin of PTLD-multiple myeloma. The BM microenvironment of the recipient might be associated with the development of PTLD-multiple myeloma.
authors.affiliation: Internal Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, 160 Ilsimri, Hwasun, Republic of Korea.
authors.forename: Young-Il
authors.initials: YI
authors.lastname: Kim
authors.forename: Hye-Ran
authors.initials: HR
authors.lastname: Kim
authors.forename: Myung-Geun
authors.initials: MG
authors.lastname: Shin
authors.forename: Young-Jin
authors.initials: YJ
authors.lastname: Lee
authors.forename: Jong-Hee
authors.initials: JH
authors.lastname: Shin
authors.forename: Soon-Pal
authors.initials: SP
authors.lastname: Suh
authors.forename: Dong-Wook
authors.initials: DW
authors.lastname: Ryang
mesh_terms: D000328:Adult; D000753:Anemia, Refractory / Q000473:pathology / Q000628:therapy*; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007621:Karyotyping; D008297:Male; D009101:Multiple Myeloma / Q000209:etiology* / Q000473:pathology; D014019:Tissue Donors