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Adverse Occurrence type:
Most recent risk assessment for leukemia, lymphoma and plasmacytoma (Council of Europe, 2022): Leukaemia, lymphoma and plasmacytoma diagnosed during donor procurement: These cancers are classified as an unacceptable risk for organ donation. Leukaemia, lymphoma and plasmacytoma in the donor history: Active (acute or chronic) leukaemia, lymphoma and plasmacytoma are an unacceptable risk for organ donation. Treated acute leukaemia and lymphoma after a definite disease-free interval of 10 years may be considered for organ donation with an assumed high risk for transmission.
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
The female recipient developed general malaise 6 months after transplantation. A mild leukopenia and thrombocytopenia was noted. Bone marrow biopsy revealed massive infiltration of blasts. The morphologic features of cells were similar to lymphoblastic lymphoma, expressing cyCD3+, Tdt+, CD1a+ and CD8+.
Demonstration of imputability or root cause:
Inmunophenotyping analysis showed the same antigenic profile of the abnormal T cells in the thymus of the donor and the bone marrow of the recipient. FISH studies for sex chromosomes were used to prove that the blastic cells in the recipient came from the donor. PCR confirmed the clonal origin of the blasts in the recipient.
Suggest new keywords:
Kidney transplant/Kidney recipient/Kidney transplantation
FISH (fluorescence in situ hybridization)
Leukemia, lymphocytic, acute lymphoblastic
Lymphoma, T cell
Kowal M, Hus M, Dmoszynska A, Kocki J, Grzasko N. Acute T cell lymphoblastic leukemia in the recipient of a renal transplant from a donor with malignant lymphoma. Acta haematologica. 2008;119(3):187-9.
Expert comments for publication:
To the author's knowledge, this is the first report of acute T cell lymphoblastic leukemia transmission from a donor with malignant T cell lymphoblastic lymphoma. Nevertheless, this paper was published in 2008, so to this date there might have been other published cases