Status:
Ready to upload
Record number:
2053
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
(Note that in this report the donor did not have disease and the development of promyelocytic leukemia was interpreted as a posttransplant event affecting donor cells, therefore this report is not considered to represent a donor disease transmitted at the time of transplant- the following comments relate to instances in which donor disease is present):
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:
Donor origin myelodysplastic syndrome found at 26 months; progression to promyelocytic leukemia diagnosed at 37 months.
Alerting signals, symptoms, evidence of occurrence:
New onset anemia seen at 26 months.
Demonstration of imputability or root cause:
PCR analysis of DNA short tandem repeats.
Imputability grade:
0 Excluded
Groups audience:
Keywords:
References:
Suggest new keywords:
Malignancy
Case Report
Living donor
Bone marrow allograft transplant
DNA typing
Leukemia, myeloid, promyelocytic
Myelodysplastic syndrome
Therapy discussed
Reference attachment:
Suggest references:
Daly AS, Kamel-Reid S, Lipton JH, Messner HA, Kiss TL, Chun K, et al. Acute leukemia of donor origin arising after stem cell transplantation for acute promyelocytic leukemia. Leuk Res. 2004;28(10):1107-11.
Note:
Reference: Daly AS, Kamel-Reid S, Lipton JH, Messner HA, Kiss TL, Chun K, Busque L, Chang H. Acute leukemia of donor origin arising after stem cell transplantation for acute promyelocytic leukemia. Leuk Res. 2004 Oct;28(10):1107-11. doi: 10.1016/j.leukres.2004.02.003. PMID: 15289025.
First review MN 4/15/22
Second review K. Moench 05/10/22
Expert comments for publication:
The recipient initially had a promyelocytic leukemia with a PML/RAR (retinoic acid receptor) translocation. Following bone marrow transplant, she eventually developed myelodysplastic syndrome and ultimately promyelocytic leukemia that arose from donor cells and did not express the PML/RAR translocation. The authors suggest that post-transplant stresses may lead to these conditions in some cases (i.e., donor-derived, not donor-transmitted, disease), and further suggest the potential of preceding undetected myelodysplastic syndrome in at least some patients who undergo hematopoietic cell transplant and later develop leukemias of donor origin. It is notable that this patient received a second bone marrow transplant from the same donor and was in remission at the time of the report. The donor was tested at the time of second transplant and demonstrated no evidence of hematopoietic abnormalities.