Donor-derived malignancy after allogeneic stem cell transplantation: a rare but well recognized complication

Area of Science:

• Hematology
• Oncology
• Transplantation Medicine

Background:

• Relapse post-allogeneic stem cell transplantation (allo-SCT) affects 30-60% of patients, often stemming from the original malignant clone.
• Donor-derived malignancy (DDM), where malignancy arises from donor cells, is increasingly recognized due to advanced chimerism analysis.
• Distinguishing DDM from original disease relapse is crucial for appropriate treatment and understanding ethical implications for donors.

Purpose of the Study:

• To systematically review and analyze donor-derived malignancy (DDM) cases reported between 2009 and 2024.
• To identify potential common characteristics or risk factors associated with the development of DDM.
• To update the understanding of DDM incidence and characteristics since the last comprehensive report in 2009.

Main Methods:

• Systematic literature review of reported DDM cases.
• Analysis of cases reported from 2009 to 2024.
• Critical evaluation of patient and donor characteristics, genetic findings, and clinical outcomes.

Main Results:

• The incidence of reported DDM cases has been increasing.
• Analysis of recent cases aims to reveal commonalities in patient, donor, or graft factors.
• Distinct clinical presentations and outcomes are expected for DDM compared to original relapse.

Conclusions:

• Understanding DDM is critical for refining allo-SCT protocols and patient care.
• Identification of predisposing factors may lead to improved donor screening and risk stratification.
• Further research is needed to elucidate the mechanisms and optimize management strategies for DDM.