Registry Series: Risk factors for Donor Derived Leukemia after Hematopoietic Cell Transplant (Leukemia, myeloid, acute myelogenous)

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MPHO Type: 
Estimated frequency: 
In this study of 305 European Society of Blood and Marrow Transplantation Centers, 46,051 allogeneic transplants ere identified and a total of 38 resulted in leukemia of donor origin The authors estimate the prevalence of this disorder as 80.5 cases per 100,000 transplants with a cumulative incidence of 0.067% at 5 years, 0.132% at 10 years and 0.363% at 25 years.
Time to detection: 
Time to diagnosis in individual patients ranged from 0.13 to 23.31 years (2-279 months). The median time from last transplant to diagnosis was 44 months.
Alerting signals, symptoms, evidence of occurrence: 
Demonstration of imputability or root cause: 
Listed for patients; typically cytogenetic or molecular analysis.
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Suggest new keywords: 
Registry series
Bone marrow allograft transplant
Allograft hematopoietic stem cell transplantation
Cytogenetic analysis
DNA typing
Leukemia, myeloid, acute myelogenous
Leukemia, lymphocytic, chronic
Myelodysplastic syndrome
FISH (fluorescence in situ hybridization)
Suggest references: 
Engel N, Rovo A, Badoglio M, Labopin M, Basak GW, Beguin Y, et al. European experience and risk factor analysis of donor cell-derived leukaemias/MDS following haematopoietic cell transplantation. Leukemia. 2019;33(2):508-17.
Please clone record for leukemia, lymphocytic, chronic and myelodysplastic syndrome under adverse occurrence type->harm to recipient->malignancy - OK (EP) Carl-Ludwig: aggree to Michael; added a sentence with ## for expert comment as this study may be helpful to understand basic issues in donor derive malignancy transfer.
Expert comments for publication: 
Detailed review of occurrence, treatment and outcomes of donor leukemia arising in the setting of hematopoietic cell transplantation. One main point of the paper is to define risk factors for this, which include: 1. use of growth factors within the first 100 days after transplant; 2. in vivo T cell depletion, and 3. multiple allografts. The authors highlight the challenge to confirm that the malignant cells are of donor origin, that the risk exists of "pre-exisitng malignant clones to be transfered accidentally" as well as not (only pre-leukemic clones) and that development to leukemia is a multistep process (due to exposure to other factors). This "modell" may be helpful to understand how donor derived malignancy may be caused in other conditions.