Evidence of Donor-Derived Hematologic Malignancies after Hematopoietic Stem Cell Transplantation

Abstract

Increasing the upper age limit for recipients of hematopoietic stem cell transplantation (HCT) naturally has also increased the age of the corresponding related donor population. Because aging is a risk factor for malignancies, the risk of transferring preexisting malignant or premalignant hemopoietic clones in the process of HCT might be expected to increase as well. Anecdotal clinical cases of malignancies derived from donor cells in patients undergoing HCT have been published since 1971. In this article, we report 12 new cases that fit 2 different categories: (1) cases in which clones with characteristics of lymphohemopoietic malignancies were transferred from the donors to the recipients and (2) cases in which the malignant clone evolved from healthy donor cells once transplanted into the recipient. Donors in the first group were significantly older than donors in the second group. A more systematic examination of the prevalence and biology of donor malignancies would merit study.

Donor cell leukemia: insight into cancer stem cells and the stem cell niche

“…Until 2005, reports of DCL were exclusively in allogeneic bone marrow HC transplant recipients; however, there have now been at least 4 cases reported in PB HC transplant recipients. 7,12 The first report in an UCB transplant recipient was in 2005 30 and was quickly followed by 2 additional cases reports. 31,32 The predominance of DCL in allogeneic BM HCTs compared with both PB and UCB may simply be a result of the longer historical use of this cell source.…”

“…In addition to de novo leukemia, there are cases documenting the occult transfer of malignant cells from donors during HCT. 7 Notably, transfer of malignant cells can also occur with solid-organ transplantation. [8][9][10] Defining the true incidence of DCL is difficult because of vagaries in its recognition and in reporting; therefore, the majority of evidence in the literature is anecdotal.…”

Genetically identical twin transplantation for chronic lymphocytic leukemia

“…Transfer of leukemia by an allotransplant is reported in several leukemias including three cases of CLL. 27,28 Sala-Torra et al 28 suggested two mechanisms of donor-derived leukemia in the recipient. The first is the transfer of preleukemia cells from donor to recipient, most likely the scenario in our patient UPN 7.…”

Neoplasms in the bone marrow niches: disturbance of the microecosystem

“…Several studies found that deletion or mutation of functional genes in these niche cells led to MPNs, myelodysplasia, or leukemia [12,[28][29][30][31][32]. These findings and accordingly raised concepts were proved by the clinical transplantation investigations, in which donor-derived hematologic malignancies after hematopoietic stem cell transplantation were diagnosed [33].…”