title: Donor cell-derived leukemias/myelodysplastic neoplasms in allogeneic hematopoietic stem cell transplant recipients: a clinicopathologic study of 10 cases and a comprehensive review of the literature.
abstract: We report 10 cases of donor cell leukemia (DCL). All cases except the case of chronic lymphocytic leukemia had anemia, neutropenia, and/or thrombocytopenia when DCL was diagnosed. Eight cases with sex-mismatched hematopoietic stem cell transplant (HCT) showed donor gonosomal complements, suggesting DCL. Clonal cytogenetic abnormalities were detected in 8 cases: 6 were monosomy 7/del(7q). In all 10 cases, engraftment studies confirmed donor cell origin. Retrospective fluorescence in situ hybridization in archived donor cells in 4 cases showed a low level of abnormalities in 2. Of 7 patients with clinical follow-up of 5 months or more, 1 (with acute myeloid leukemia) died of disease; 6 are alive, including 1 with myelodysplastic syndrome with spontaneous remission. Similar to reported cases, we found disproportional sex-mismatched HCTs, suggesting probable underdetection of DCL in sex-matched HCTs. The latency between HCT and DCL ranged from 1 to 193 months (median, 24 months), in keeping with the literature. Analyzing our cases, pooled with reported cases, with survival models showed much shorter latency for malignancy as primary disease, for T-cell large granular lymphocyte leukemia as type of DCL, and for umbilical cord blood as stem cell source.
authors.affiliation: Dept of Pathology, Duke University Medical Center, Durham, NC, USA.
authors.forename: Endi
authors.initials: E
authors.lastname: Wang
authors.forename: Charles Blake
authors.initials: CB
authors.lastname: Hutchinson
authors.forename: Qin
authors.initials: Q
authors.lastname: Huang
authors.forename: Chuanyi Mark
authors.initials: CM
authors.lastname: Lu
authors.forename: Jennifer
authors.initials: J
authors.lastname: Crow
authors.forename: Frances F
authors.initials: FF
authors.lastname: Wang
authors.forename: Siby
authors.initials: S
authors.lastname: Sebastian
authors.forename: Catherine
authors.initials: C
authors.lastname: Rehder
authors.forename: Anand
authors.initials: A
authors.lastname: Lagoo
authors.forename: Mitchell
authors.initials: M
authors.lastname: Horwitz
authors.forename: David
authors.initials: D
authors.lastname: Rizzieri
authors.forename: Jingwei
authors.initials: J
authors.lastname: Yu
authors.forename: Barbara
authors.initials: B
authors.lastname: Goodman
authors.forename: Michael
authors.initials: M
authors.lastname: Datto
authors.forename: Patrick
authors.initials: P
authors.lastname: Buckley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002471:Cell Transformation, Neoplastic / Q000235:genetics / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D002869:Chromosome Aberrations; D002999:Clone Cells; D005260:Female; D005434:Flow Cytometry; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D016130:Immunophenotyping; D017404:In Situ Hybridization, Fluorescence; D007621:Karyotyping; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D011183:Postoperative Complications; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D014019:Tissue Donors; D014184:Transplantation, Homologous; D055815:Young Adult