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Adverse Occurrence type:
Most recent risk assessment for lymphoma (Council of Europe, 2018): donors with active lymphoma are considered to represent an unacceptable risk for tumor transmission. Insufficient data exist at present to discriminate among different lymphoma subtypes. Donors with a history of treated lymphoma after a disease-free interval of 5 to 10 years are assumed to represent a high risk for transmission.
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
A neoplastic lesion appeared on the patient's head and was biopsied. The lesion was an EBV negative diffuse large B cell lymphoma (around this time the patient also had an episode of GVHD, pneumonia and hemorrhagic cystitis that were treated).
Demonstration of imputability or root cause:
FISH analysis for XY chromosome showed that the tumor was comprised of male cells form the female patient's donor (father).
Suggest new keywords:
Allograft hematopoietic stem cell transplantation
Lymphoma, B cell, diffuse large type
Xie L, Zhou F. Development of lymphoma from the donor of haploidentical stem cell transplantation: A case report. Mol Clin Oncol. 2017;7(5):851-4.
carl-ludwig: agree to MIchael. Agree to B-cell Lymphoma originating from donor -> unexpected time course, but definitively possible.
Expert comments for publication:
One year after donation the father developed diffuse large B cell lymphoma. Both father and daughter received chemotherapy (daughter also had withdrawal of immunosuppression, father also underwent autologous stem cell transplant) and underwent remission and were free of disease at last followup. The authors describe this as a form of PTLD. We would consider it an example of donor transmitted lymphoma, not related to the spectrum of posttransplant lymphoproliferative disorders that arise in a minority of transplant recipients.