title: Donor-derived myeloid sarcoma in two kidney transplant recipients from a single donor.
abstract: We report the rare occurrence of donor-derived myeloid sarcoma in two kidney transplant patients who received organs from a single deceased donor. There was no evidence of preexisting hematologic malignancy in the donor at the time of organ recovery. Both recipients developed leukemic involvement that appeared to be limited to the transplanted organ. Fluorescence in situ hybridization (FISH) and molecular genotyping analyses confirmed that the malignant cells were of donor origin in each patient. Allograft nephrectomy and immediate withdrawal of immunosuppression were performed in both cases; systemic chemotherapy was subsequently administered to one patient. Both recipients were in remission at least one year following the diagnosis of donor-derived myeloid sarcoma. These cases suggest that restoration of the immune system after withdrawal of immunosuppressive therapy and allograft nephrectomy may be sufficient to control HLA-mismatched donor-derived myeloid sarcoma without systemic involvement.
authors.affiliation: Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: Amudha
authors.initials: A
authors.lastname: Palanisamy
authors.affiliation: Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Persad
authors.affiliation: Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: Patrick P
authors.initials: PP
authors.lastname: Koty
authors.affiliation: Department of Internal Medicine, Section on Hematology and Oncology, Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC 27103, USA.
authors.forename: Laurie L
authors.initials: LL
authors.lastname: Douglas
authors.affiliation: Department of General Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stratta
authors.affiliation: Department of General Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Rogers
authors.affiliation: Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: Amber M
authors.initials: AM
authors.lastname: Reeves-Daniel
authors.affiliation: Department of General Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Orlando
authors.affiliation: Department of General Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Farney
authors.affiliation: Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Beaty
authors.affiliation: Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Pettenati
authors.affiliation: Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: Samy S
authors.initials: SS
authors.lastname: Iskandar
authors.affiliation: Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: David D
authors.initials: DD
authors.lastname: Grier
authors.affiliation: Department of Pharmacy, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Kaczmorski
authors.affiliation: Department of Pharmacy, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: William H
authors.initials: WH
authors.lastname: Doares
authors.affiliation: Department of General Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Gautreaux
authors.affiliation: Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA.
authors.forename: Barry I
authors.initials: BI
authors.lastname: Freedman
authors.affiliation: Department of Internal Medicine, Section on Hematology and Oncology, Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC 27103, USA.
authors.forename: Bayard L
authors.initials: BL
authors.lastname: Powell