title: Recurrence of monoclonal gammopathy associated with donor-derived myelodysplastic syndrome after cord blood stem cell transplantation.
abstract: Myelodysplastic syndrome (MDS) is known to be associated with functional abnormalities of B cells, including hypergammaglobulinemia and monoclonal gammopathy (MG). However, the pathogenesis of these immunological disorders has not been clarified. We report a patient who developed donor-derived MDS followed by leukemic transformation after cord blood transplantation for MDS with MG. Interestingly, MG reappeared before development of donor-derived MDS. We analyzed the immunoglobulin allotype gene polymorphisms to determine whether the MG after cord blood transplantation was of recipient origin or donor origin. Results of genetic analysis and enzyme-linked immunosorbent assay of IgG1 allotype revealed that the MG after cord blood transplantation was of donor origin. Although the mechanism of donor-derived MG remains unclear, the persistent presence of recipient's antigen presenting cells might have induced the abnormal immunoglobulin production.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Yamazaki
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakasone
authors.forename: Hidenori
authors.initials: H
authors.lastname: Wada
authors.forename: Kana
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ashizawa
authors.forename: Miki
authors.initials: M
authors.lastname: Sato
authors.forename: Kiriko
authors.initials: K
authors.lastname: Terasako
authors.forename: Misato
authors.initials: M
authors.lastname: Kikuchi
authors.forename: Shun-Ichi
authors.initials: S
authors.lastname: Kimura
authors.forename: Shinya
authors.initials: S
authors.lastname: Okuda
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kako
authors.forename: Yukie
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Aki
authors.initials: A
authors.lastname: Tanihara
authors.forename: Kumi
authors.initials: K
authors.lastname: Oshima
authors.forename: Junji
authors.initials: J
authors.lastname: Nishida
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
mesh_terms: D000754:Anemia, Refractory, with Excess of Blasts / Q000209:etiology*; D001402:B-Lymphocytes / Q000473:pathology; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D004273:DNA, Neoplasm / Q000032:analysis; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007126:Immunoglobulin Allotypes / Q000235:genetics; D007145:Immunoglobulin kappa-Chains; D007231:Infant, Newborn; D007518:Isoantibodies / Q000276:immunology; D007951:Leukemia, Myeloid / Q000209:etiology; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010265:Paraproteinemias / Q000150:complications / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D013601:T-Lymphocytes / Q000473:pathology; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous / Q000009:adverse effects
chemical_list: D004273:DNA, Neoplasm; D007126:Immunoglobulin Allotypes; D007145:Immunoglobulin kappa-Chains; D007518:Isoantibodies