title: Development of donor cell leukemia mimicking hematogones after unrelated cord blood transplantation for relapsed acute lymphoblastic leukemia.
abstract: A 26-year-old woman, who developed ALL when she was eighteen years old, achieved remission after chemotherapy. Her ALL relapsed when she was twenty-two years old. After re-induction therapy, she underwent cord blood transplantation. Her bone marrow examination on the 42nd day revealed a lymphoblast count of 16%. She was observed without any therapy, but her bone marrow blast count continued to be around 6% for three years without any symptoms. The bone marrow blast fraction originated from the cord blood. Surface marker analysis of the blast fraction initially revealed a pattern of hematogones that was CD10 and CD19 positive, but then showed a myeloblast pattern that was CD13 and CD33 positive. AML developed as donor cell leukemia. When blasts appear in the early phase after transplantation and persist, an observation period is necessary with molecular chimerism, morphology, and surface marker analysis of the blast fraction to consider relapse, hematogones, or donor cell leukemia.
authors.affiliation: Department of Hematology, Japanese Red Cross Wakayama Medical Center.
authors.forename: Keigo
authors.initials: K
authors.lastname: Hamahata
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Kotani
authors.forename: Satoko
authors.initials: S
authors.lastname: Oka
authors.forename: Naoya
authors.initials: N
authors.lastname: Ukyo
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Watanabe
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nogawa
mesh_terms: D000328:Adult; D018941:Antigens, CD19; D001782:Blood Donors; D001854:Bone Marrow Cells / Q000166:cytology*; D018826:CD13 Antigens; D002452:Cell Count; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D042381:Granulocyte Precursor Cells; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D015260:Neprilysin; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D063268:Sialic Acid Binding Ig-like Lectin 3
chemical_list: D018941:Antigens, CD19; D063268:Sialic Acid Binding Ig-like Lectin 3; D018826:CD13 Antigens; D015260:Neprilysin