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[Donor cell leukemia (DCL): A prospective study of its identification and treatment]

Guillermo J Ruiz-Delgado1,2,3, Jesús Hernández-Reyes1,4, Mónica Patricia González-Ramírez1,5

  • 1Centro de Hematología y Medicina Interna, Clínica Ruiz de Puebla, Puebla, Pue., México.

Gaceta Medica De Mexico
|November 4, 2015
PubMed

Insights

Donor cell leukemia, a rare complication of stem cell transplants, may be more common than previously thought. Prompt chemotherapy offers a chance for remission in these patients.

Area of Science:

  • Hematology
  • Oncology
  • Transplantation Immunology

Context:

  • Donor-derived malignancies are rare post-transplant complications.
  • Allogeneic hematopoietic stem cell transplantation (HSCT) and solid organ transplantation (SOT) carry risks.
  • Donor cell leukemia (DCL) is an exceptionally rare entity.

Purpose:

  • To prospectively investigate the incidence of DCL in leukemia patients undergoing HSCT.
  • To evaluate the efficacy of a pediatric-inspired chemotherapy regimen for DCL.
  • To assess outcomes and long-term status of DCL survivors.

Summary:

  • Seven cases of DCL were identified over 12 years in 106 leukemia patients receiving HSCT.
  • Six cases involved donor cell acute lymphoblastic leukemia (ALL), treated with combined chemotherapy.
  • Three of six DCL patients achieved complete response; survivors remained full chimeras without needing a second transplant.

Impact:

  • Suggests the incidence of DCL may be underestimated.
  • Demonstrates the potential for favorable responses to combined chemotherapy in DCL.
  • Highlights the possibility of long-term survival without further transplantation for DCL patients.

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