Donor Cell Myeloid Sarcoma in an Umbilical Cord Transplant Patient: A Case Report and a Review of the Literature

Abstract

Donor cell leukemia (DCL) represents a rare complication of allogeneic transplantation. The precise incidence remains unclear, though it may be higher following umbilical cord blood transplants. Here, we present an unusual case of a patient with B-ALL who presented with a donor derived myeloid sarcoma of the heart following a double cord blood transplant. To our knowledge, it is the first case of sarcomatous or chloromatous presentation of DCL following a UCBT.

Donor cell leukemia/myelodysplastic syndrome after allogeneic stem cell transplantation: a rare phenomenon with more challenges for hematologists

“…Although DCL or DC-MDS is a rare disease, it has to be diagnosed early. The prognosis of DCL is usually extremely poor, consistent with other secondary leukemias with a median of 5.5-month OS [2,3,10,11]. Two cases from our observation remained in CR for 12 and 8 months.…”

“…DCL is a rare phenomenon after allogeneic hematopoietic stem cell transplantation (allo-HSCT) since its first report in 1971. Emerging evidence suggests that DCL may account for 5% of all posttransplant leukemia relapses, even higher after cord blood transplants [1,2]. Here we reported one case of acute lymphocytic leukemia (ALL) and one case of MDS of donor origin after allo-HSCT from a total of 1650 patients who received HSCT between January 2000 and September 2020 from our hospital and followed standard ethical procedures (Supplementary information).…”

“…The spike of incidence reported recently may be largely due to the improvement in detection methods with molecular analysis and cytogenetic advances. Even with the increase of the incidence reported recently, researchers still believed that there were the underestimated cases than the actual cases and suggested that improved molecular testing would allow precise detection and avoid mistakenly categorizing DCL as a relapsed disease [2,3]. Several detection strategies, including conventional cytogenetics and fluorescent in situ hybridization (FISH), variable number of tandem repeats (VNTRs) and STR polymorphism, as well as whole-exome sequencing, have been used [3].…”

Tissue-based chimerism analysis enhances detection of donor-derived neoplasia in allogeneic stem cell transplant patients

“…The authors declare no conflict of interest. Wang et al 14 9 CML (3), ALL (2), AML (1) NHL (2) ALCL (1) MDS (7), AML (1), CLL (1) Xiao et al 15 1 AML AML Rodriguez-Macias et al 16 1 ALL AML Bobadilla-Morales et al 17 1 AML AML Ruiz-Delgado et al 18 7 ALL (6), PNH/AA (1) ALL (6), HCL (1) Hayes et al 19 1 ALL MS Kurosawa et al 20 1 CML ALL Hirsch et al 21 1 AML AML Gondek et al 7 2 AML (1), NHL (1) AML (1), MDS (1) Maestas et al 22 1 CML Myeloma Cutting et al 23 1 CML AML Total 108 ALL (32), CML (25), AML 23…”