Acute leukemia of donor origin arising after stem cell transplantation for acute promyelocytic leukemia

Daly, Andrew S; Kamel-Reid, Suzanne; Lipton, Jeffrey H; Messner, Hans A; Kiss, Thomas L; Chun, Kathy; Busque, Lambert; Chang, Hong

doi:10.1016/j.leukres.2004.02.003

« Previous Next »Leukemia Research
Volume 28, Issue 10 , Pages 1107-1111, October 2004

Acute leukemia of donor origin arising after stem cell transplantation for acute promyelocytic leukemia

Andrew S Daly
- Allogeneic Bone Marrow Transplant Service, Department of Medical Oncology and Hematology, Princess Margaret Hospital/University Health Network, 610 University Avenue, Toronto, Ont., Canada M5G 2M9
Suzanne Kamel-Reid
- Department of Pathology, University Health Network, Department of Cellular and Molecular Biology, Ontario Cancer Institute/Princess Margaret Hospital, 610 University Avenue, Toronto, Ont., Canada M5G 2M9
Jeffrey H Lipton
- Allogeneic Bone Marrow Transplant Service, Department of Medical Oncology and Hematology, Princess Margaret Hospital/University Health Network, 610 University Avenue, Toronto, Ont., Canada M5G 2M9
Hans A Messner
- Allogeneic Bone Marrow Transplant Service, Department of Medical Oncology and Hematology, Princess Margaret Hospital/University Health Network, 610 University Avenue, Toronto, Ont., Canada M5G 2M9
Thomas L Kiss
- Allogeneic Bone Marrow Transplant Service, Department of Medical Oncology and Hematology, Princess Margaret Hospital/University Health Network, 610 University Avenue, Toronto, Ont., Canada M5G 2M9
Kathy Chun
- Department of Pathology, University Health Network, Department of Cellular and Molecular Biology, Ontario Cancer Institute/Princess Margaret Hospital, 610 University Avenue, Toronto, Ont., Canada M5G 2M9
Lambert Busque
- Division of Hematology, Hospital Maisonneuve-Rosemont, Universite de Montreal, Canada
Hong Chang
- Department of Laboratory Hematology, Princess Margaret Hospital, University Health Network, 610 University Avenue, Toronto, Ont., Canada M5G 2M9
- Corresponding author. Tel.: +1-416-946-4635; fax: +1-416-946-4616.

Received 9 December 2003; accepted 11 February 2004.

Abstract

We report a patient with PML/RARα-positive acute promyelocytic leukemia (APL) who developed PML/RARα-negative acute myeloid leukemia 37 months after allogeneic bone marrow (BMT) transplant for molecular relapse. Features of myelodysplasia were noted 11 months earlier, chimerism testing by analysis of short tandem repeats was consistent with development of myelodysplasia and acute leukemia within cells of donor origin. To our knowledge, this is the first report of donor cell leukemia following BMT for APL. We hypothesize that replicative stress may lead to the development of some cases of donor cell acute leukemia.

Keywords: Donor cell leukemia, Acute promyelocytic leukemia, Allogeneic bone marrow transplantation