title: Donor-derived mycosis fungoides following reduced intensity haematopoietic stem cell transplantation from a matched unrelated donor.
abstract: A 46-year-old woman with a history of dasatinib-resistant chronic myeloid leukaemia, clonal evolution and monosomy 7 underwent reduced intensity conditioned in vivo T-cell-depleted allogeneic haematopoietic stem cell transplantation (HSCT) from a matched unrelated donor. Following the transplantation, she developed recurrent cutaneous graft versus host disease (GvHD), which required treatment with systemic immunosuppression and electrocorporeal photophoresis. Concurrently, she developed a lichenoid rash with granulomatous features suggestive of cutaneous sarcoidosis. Additional treatment with hydroxychloroquine was initially successful, but 2 months later, she developed erythroderma with palpable lymphadenopathy. Repeated histological analysis established a diagnosis of folliculotropic mycosis fungoides stage IVA2, and the malignant clone was confirmed to be of donor origin. A positive response to brentuximab has been shown. This is the first reported case of primary mycosis fungoides after matched unrelated donor HSCT, and in a patient still undergoing treatment for GvHD.
authors.affiliation: Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
authors.forename: Francesca A M
authors.initials: FA
authors.lastname: Kinsella
authors.affiliation: Department of Cellular Pathology, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Mohammad Rasoul
authors.initials: MR
authors.lastname: Amel Kashipaz
authors.affiliation: Department of Dermatology, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Scarisbrick
authors.affiliation: Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
authors.forename: Ram
authors.initials: R
authors.lastname: Malladi
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology* / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy; D009182:Mycosis Fungoides / Q000188:drug therapy / Q000209:etiology*; D012878:Skin Neoplasms / Q000188:drug therapy / Q000209:etiology*; D018183:Transplantation Chimera; D014184:Transplantation, Homologous / Q000009:adverse effects; D016896:Treatment Outcome; D061349:Unrelated Donors