Donor cell-derived acute lymphocytic leukemia after allogeneic stem cell transplantation for multiple myeloma

• Published in: International journal of hematology Vol. 90; no. 3; pp. 378 - 382
• Main Authors: Igarashi, Natsue, Chou, Takaaki, Hirose, Takayuki, Imai, Yousuke, Ishiguro, Takuro, Nemoto, Keiichi
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.10.2009; Springer; Springer Nature B.V
• Subjects: Antineoplastic Agents - therapeutic use; Antineoplastic Agents, Hormonal - therapeutic use; Biological and medical sciences; Bone Marrow Transplantation - adverse effects; Boronic Acids - therapeutic use; Bortezomib; Case Report; Dexamethasone - therapeutic use; Fatal Outcome; Hematologic and hematopoietic diseases; Hematology; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Immunodeficiencies. Immunoglobulinopathies; Immunoglobulinopathies; Immunopathology; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multiple Myeloma - therapy; Oncology; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Precursor Cell Lymphoblastic Leukemia-Lymphoma - etiology; Pyrazines - therapeutic use; Tissue Donors; Transplantation, Homologous; Donor cell leukemia; Allo-BMT; Bortezomib; Multiple myeloma; Antineoplastic agent; Immunopathology; Hematology; Stem cell; Hematopoietic cell; Homograft; Malignant hemopathy; Myeloma; Immunoglobulinopathy; Donor; Analog; Proteasome inhibitor; Lymphoproliferative syndrome; Dipeptides; Bone marrow; Graft; Acute lymphocytic leukemia; Cancer
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/s12185-009-0397-z

Donor cell leukemia (DCL) is a rare, but well-known, complication after allogeneic hematopoietic cell transplantation. We report a case of donor cell-derived acute lymphocytic leukemia (ALL) occurring in a 55-year-old man after allogeneic bone marrow transplantation (allo-BMT) from an HLA-matched unrelated donor for refractory multiple myeloma (MM). Molecular analysis using short tandem repeat sequences proved the ALL to be of donor origin. He underwent combination chemotherapy and second allo-BMT from an alternative donor. After second allo-BMT, extramedullary myeloma relapsed as tumor, but was successfully treated with proteasome inhibitor, bortezomib. However, he died from severe graft-versus-host disease four months after the second transplantation. Although more than 50 cases of DCL have been reported, there have been only two reports of DCL developed in MM patients including our case. This rare complication may give some insights into leukemogenesis.