Transient donor cell‐derived myelodysplastic syndrome with monosomy 7 after unrelated cord blood transplantation

Abstract

Donor cell leukaemia or myelodysplastic syndromes are extremely rare complications that have been observed not only after haematopoietic transplantation with progenitor cells harvested from bone marrow and peripheral blood, but also after cord blood transplantation. We describe the early onset of monosomy 7 in donor cells after cord blood transplantation in a patient diagnosed with myelodysplastic syndrome 3 months after transplantation. Fluorescent in situ hybridisation analysis performed in a cryopreserved aliquot of the cord blood showed 2.5% of nuclei with monosomy 7. The cord blood donor was studied and he showed neither peripheral blood cytopenias nor cytological or cytogenetic features of myelodysplasia. The cell blood counts (CBC) of the girl have improved over 2 yr while decreasing the percentage of monosomic cells. The monosomic clone has finally disappeared and the CBC are finally normal. This case of transient monosomy 7 started very early after engraftment emphasises the relevance of clonal instability of specific progenitor cells in the early engraftment, and host immune status, in cytogenetic abnormalities founded in donor cell-derived MDS and acute leukaemia. Moreover, the clinical follow-up of this patient, recommends a more conservative treatment for this clonal disease early developed after transplantation.

Transplantation of a myelodysplastic syndrome by a long-term repopulating hematopoietic cell

“…However, engraftment was transient in some cases, clonal markers indicated that 15-99% of the cells were derived from normal hematopoietic cells, and there was no evidence that the mice developed peripheral blood cytopenias or other evidence of clinical MDS. Rare case reports of donor-derived MDS in BM transplant recipients have suggested that MDS may be transplantable (27), although in most of these reports, there was no convincing evidence that the donor had MDS.…”

An unusual case of donor‐derived myelodysplastic syndrome following double‐unit umbilical cord blood transplantation in acute lymphoblastic leukemia

“…Donor-derived hematologic neoplasms are now recognized as a potential complication of UCB HSCT. Donor-derived EBV 1 B-cell PTLD and ddMDS/ddAML has also been previously reported after UCB HSCT [12][13][14][15][16][17][18][19][20]. Kaplan-Meier analysis of pooled data on 13 cases of ddAML after UCB HSCT seems to show an increased risk of ddAML, when compared with other sources of stem cells [21].…”

Leukemic Transformation of Severe Aplastic Anemia Following Matched Allogenic Stem Cell Transplantation, Transplanted Again in CR 1

“…There are only six case reports highlighting that leukemic transformation may originate from donor cells after BMT for SAA [3,[10][11][12][13][14]. Rarely, this transformation also been reported after unrelated umbilical cord blood [15,16].…”