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Bone Marrow Transplantation Platform to Investigate the Role of Dendritic Cells in Graft-versus-Host Disease

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Published on: March 17, 2020

Donor cell leukemia with bone marrow necrosis.

Shuntaro Ikegawa¹, Yuho Najima, Naoki Sano

¹Hematology Division, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital.

[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology

|December 13, 2016

Summary

A rare case of donor cell leukemia (DCL) developed in a patient with myelodysplastic syndrome post-transplant. This leukemia was associated with bone marrow necrosis and ultimately led to fatal sepsis.

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Area of Science:

Hematology
Oncology
Transplantation Immunology

Background:

Allogeneic stem cell transplantation is a curative therapy for myelodysplastic syndromes.
Donor cell leukemia (DCL) is a rare but serious complication following allogeneic transplantation.

Observation:

A 60-year-old man with myelodysplastic syndrome developed hemophagocytic syndrome (HPS) post-allogeneic umbilical cord blood transplant.
Bone marrow examination revealed bone marrow necrosis (BMN) and abnormal cells.
Genetic analysis confirmed donor chimerism and revealed chromosomal abnormalities.

Findings:

The patient was diagnosed with donor cell leukemia (DCL) with associated bone marrow necrosis (BMN).
Treatment with HLH-2004 protocol showed initial improvement but was followed by the emergence of abnormal cells.
The patient succumbed to pneumonia and sepsis.

Implications:

This case highlights the potential for DCL development after umbilical cord blood transplantation.
The association of DCL with BMN presents a diagnostic and therapeutic challenge.
Further research is needed to understand the pathogenesis and improve outcomes for DCL.