1
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Asurappulige HSH, Ladomery MR, Ruth Morse H. IL-6 knockdown in a model of the human bone marrow, abrogates DNA damage induction in bystander cells post-chemotherapy induced cytokine release syndrome. Transl Oncol 2024; 46:102030. [PMID: 38870677 PMCID: PMC11222933 DOI: 10.1016/j.tranon.2024.102030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 05/08/2024] [Accepted: 06/05/2024] [Indexed: 06/15/2024] Open
Abstract
Following infection or exposure to therapeutic agents, an aggressive immune response may result, termed cytokine storm (CS) or cytokine release syndrome. Here the innate immune system becomes uncontrolled, leading to serious consequences including possible death. Patients surviving CS are at greater risk for de novo tumorigenesis, but it is unclear if any specific cytokines are directly responsible for this outcome. De novo tumorigenesis has been observed in donated cells exposed to CS following haematopoietic stem cell transplant (HSCT). Modelling HSCT, we firstly demonstrated the release of CS levels from the HS-5 human bone marrow stromal cell line, post-exposure to chemotherapy. We then exposed the TK6 lymphoblast cell line to healthy and storm doses of IL-6 and measured increased genotoxicity via the micronucleus assay. During HSCT, haematopoietic cells are exposed to a complex mix of cytokines, so to determine if IL-6 was integral in a chemotherapy-induced bystander effect, we attempted to inhibit IL-6 from HS-5 cells using resatorvid or siRNA, treated with chlorambucil or mitoxantrone, and then co-cultured with bystander TK6 cells. Whilst resatorvid did not reduce IL-6 and did not reduce micronuclei in the bystander TK6 cells, siRNA inhibition reduced IL-6 to healthy in vivo levels, and micronuclei aligned with untreated controls. Our data suggests that exposure to high IL-6 (in the absence of inflammatory cells) has potential to induce genetic damage and may contribute to de novo tumorigenesis post-CS. We suggest that for individuals with a pro-inflammatory profile, anti-IL-6 therapy may be an appropriate intervention to prevent complications post-CS.
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Affiliation(s)
- Harshini S H Asurappulige
- Centre for Research in Biosciences, College of Health, Science and Society, University of the West of England, Bristol, BS16 1QY, UK
| | - Michael R Ladomery
- Centre for Research in Biosciences, College of Health, Science and Society, University of the West of England, Bristol, BS16 1QY, UK
| | - H Ruth Morse
- Centre for Research in Biosciences, College of Health, Science and Society, University of the West of England, Bristol, BS16 1QY, UK.
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2
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Torres-Esquius S, Beas F, Chen-Liang TH, Pomares H, Santiago M, Varela ND, Liquori A, Hernandez F, Xicoy B, Hermosín L, Arnan M, Tazón-Vega B, Blanco A, Cervera J, Diez-Campelo M, Lozano ML, Valcárcel D, Bosch F, Montoro MJ, Jerez A. Germline assessment for alloHSCT candidates over 50 years: A 'Fast-Track' screening in myeloid neoplasms. Br J Haematol 2024; 205:503-509. [PMID: 38639421 DOI: 10.1111/bjh.19460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/11/2024] [Accepted: 04/02/2024] [Indexed: 04/20/2024]
Abstract
Patients aged 50 or above diagnosed with myeloid neoplasms (MNs) are typically not candidates for germline testing. However, approximately 8% carry pathogenic germline variants. Allogeneic haematopoietic stem cell transplantation (alloHSCT) remains an option for those aged over 50; neglecting germline testing could mask the risk for relative donor cell-derived MN. We propose a germline-augmented somatic panel (GASP), combining MN predisposition genes with a myeloid somatic panel for timely germline variant identification when initial testing is not indicated. Out of our 133 whole-exome-sequenced MN cases aged over 50 years, 9% had pathogenic/likely variants. GASP detected 92%, compared to 50% with somatic-only panel. Our study highlights the relevance of germline screening in MN, particularly for alloHSCT candidates without established germline-testing recommendations.
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Affiliation(s)
- Sara Torres-Esquius
- Department of Hematology, Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Francisco Beas
- Department of Hematology, Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Tzu Hua Chen-Liang
- Department of Hematology, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, CIBERER-ISCIII, Murcia, Spain
| | - Helena Pomares
- Department of Hematology, Institut Català d'Oncologia. Hospital Duran i Reynals, IDIBELL. Hospitalet, Badalona, Barcelona, Spain
| | - Marta Santiago
- Department of Hematology, Hospital Universitario y Politecnico La Fe, Valencia, Spain
| | - Nicolás Díaz Varela
- Department of Hematology, Hospital Universitario Central de Asturias, Instituto. Universitario (IUOPA), Instituto de Investigación del Principado de Asturias (ISPA), Oviedo, Spain
| | - Alessandro Liquori
- Department of Hematology, Hospital Universitario y Politecnico La Fe, Valencia, Spain
| | | | - Blanca Xicoy
- Department of Hematology, Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - Montserrat Arnan
- Department of Hematology, Institut Català d'Oncologia. Hospital Duran i Reynals, IDIBELL. Hospitalet, Badalona, Barcelona, Spain
| | - Bárbara Tazón-Vega
- Department of Hematology, Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Adoración Blanco
- Department of Hematology, Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - José Cervera
- Department of Hematology, Hospital Universitario y Politecnico La Fe, Valencia, Spain
| | - María Diez-Campelo
- Department of Hematology, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - María Luisa Lozano
- Department of Hematology, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, CIBERER-ISCIII, Murcia, Spain
| | - David Valcárcel
- Department of Hematology, Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Francesc Bosch
- Department of Hematology, Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Maria Julia Montoro
- Department of Hematology, Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Andrés Jerez
- Department of Hematology, Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
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3
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Hoffmann M, Banz Y, Halter J, Schoumans J, Tchinda J, Bacher U, Pabst T. True Donor Cell Leukemia after Allogeneic Hematopoietic Stem Cell Transplantation: Diagnostic and Therapeutic Considerations-Brief Report. Curr Oncol 2024; 31:2067-2075. [PMID: 38668056 PMCID: PMC11049222 DOI: 10.3390/curroncol31040153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 03/27/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Donor cell leukemia (DCL) is a rare complication after allogeneic hematopoietic stem cell transplantation (HSCT) accounting for 0.1% of relapses and presenting as secondary leukemia of donor origin. Distinct in phenotype and cytogenetics from the original leukemia, DCL's clinical challenge lies in its late onset. Its origin is affected by donor cell anomalies, transplant environment, and additional mutations. A 43-year-old woman, treated for early stage triple-negative breast cancer, developed mixed-phenotype acute leukemia (MPAL), 12 years later. Following induction chemotherapy, myeloablative conditioning, and allo-HSCT from her fully HLA-matched brother, she exhibited multiple cutaneous relapses of the original leukemia, subsequently evolving into DCL of the bone marrow. Cytogenetic analysis revealed a complex male karyotype in 20 out of 21 metaphases, however, still showing the MPAL phenotype. DCL diagnosis was confirmed by 90.5% XY in FISH analysis and the male karyotype. Declining further intensive chemotherapy including a second allo-HSCT, she was subsequently treated with repeated radiotherapy, palliative systemic therapies, and finally venetoclax and navitoclax but died seven months post-DCL diagnosis. This case underlines DCL's complexity, characterized by unique genetics, further complicating diagnosis. It highlights the need for advanced diagnostic techniques for DCL identification and underscores the urgency for early detection and better prevention and treatment strategies.
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Affiliation(s)
- Michèle Hoffmann
- Department of Medical Oncology, Inselspital Bern, Bern University Hospital, University of Bern, 3012 Bern, Switzerland;
| | - Yara Banz
- Institute of Tissue Medicine and Pathology, University of Bern, 3012 Bern, Switzerland;
| | - Jörg Halter
- Division of Hematology, University Hospital Basel, 4031 Basel, Switzerland;
| | - Jacqueline Schoumans
- Oncogenomic Laboratory, Service and Central Laboratory of Hematology, University Hospital Lausanne (CHUV), 1005 Lausanne, Switzerland;
| | - Joëlle Tchinda
- Laboratory for Oncology, University Children’s Hospital Zürich, 8032 Zürich, Switzerland;
- Department of Hematology and Central Laboratory, Inselspital Bern, Bern University Hospital, University of Bern, 3012 Bern, Switzerland;
| | - Ulrike Bacher
- Department of Hematology and Central Laboratory, Inselspital Bern, Bern University Hospital, University of Bern, 3012 Bern, Switzerland;
| | - Thomas Pabst
- Department of Medical Oncology, Inselspital Bern, Bern University Hospital, University of Bern, 3012 Bern, Switzerland;
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4
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Pryce A, Van Eerden E, Cody M, Oakes J, DeSalvo A, Bannon S, Burlton C, Pawson R, Fingrut W, Barriga F, Ward J, Ingram C, Walsh M, El-Ghariani K, Ocheni S, Machin L, Allan D, Mengling T, Anthias C. Genetic Findings of Potential Donor Origin following Hematopoietic Cell Transplantation: Recommendations on Donor Disclosure and Genetic Testing from the World Marrow Donor Association. Transplant Cell Ther 2024; 30:143-154. [PMID: 38056629 DOI: 10.1016/j.jtct.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/23/2023] [Accepted: 11/23/2023] [Indexed: 12/08/2023]
Abstract
Following hematopoietic cell transplantation (HCT), recipients are subjected to extensive genetic testing to monitor the efficacy of the transplantation and identify relapsing malignant disease. This testing is increasingly including the use of large gene panels, which may lead to incidental identification of genetic and molecular information of potential donor origin. Deciphering whether variants are of donor origin, and if so, whether there are clinical implications for the donor can prove challenging. In response to queries from donor registries and transplant centers regarding best practices in managing donors when genetic mutations of potential donor origin are identified, the Medical Working Group of the World Marrow Donor Association established an expert group to review available evidence and develop a framework to aid decision making. These guidelines aim to provide recommendations on predonation consenting, postdonation testing of recipients, and informing and managing donors when findings of potential donor origin are identified in recipients post-transplantation. It is recognized that registries will have different access to resources and financing structures, and thus whenever possible, we have made suggestions on how recommendations can be adapted.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Jane Ward
- South African Bone Marrow Registry, Cape Town, South Africa
| | | | | | | | | | - Laura Machin
- Lancaster University, United Kingdom; Imperial College London, London, United Kingdom
| | | | | | - Chloe Anthias
- Anthony Nolan, London, United Kingdom; Royal Marsden Hospital, London, United Kingdom.
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5
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Klausner M, Phan B, Morsberger L, Parish R, Shane A, Park R, Gocke CD, Xian RR, Jones RJ, Bolaños-Meade J, Gondek LP, Phan M, Zou YS. Donor cell-derived genetic abnormalities after sex mismatched allogeneic cell transplantation: a unique challenge of donor cell leukemia. Blood Cancer J 2023; 13:163. [PMID: 37926709 PMCID: PMC10625970 DOI: 10.1038/s41408-023-00938-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/16/2023] [Accepted: 10/25/2023] [Indexed: 11/07/2023] Open
Affiliation(s)
- Melanie Klausner
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Brian Phan
- The College of William and Mary, Williamsburg, VA, USA
| | - Laura Morsberger
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rebecca Parish
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alison Shane
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rebecca Park
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christopher D Gocke
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rena R Xian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rick John Jones
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Javier Bolaños-Meade
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lukasz P Gondek
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael Phan
- The Johns Hopkins University, Baltimore, MD, USA
| | - Ying S Zou
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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6
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Asurappulige HSH, Thomas AD, Morse HR. Genotoxicity of cytokines at chemotherapy-induced 'storm' concentrations in a model of the human bone marrow. Mutagenesis 2023; 38:201-215. [PMID: 37326959 PMCID: PMC10448863 DOI: 10.1093/mutage/gead018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 06/14/2023] [Indexed: 06/17/2023] Open
Abstract
Donor cell leukaemia (DCL) is a complication of haematopoietic stem cell transplantation where donated cells become malignant within the patient's bone marrow. As DCL predominates as acute myeloid leukaemia, we hypothesized that the cytokine storm following chemotherapy played a role in promoting and supporting leukaemogenesis. Cytokines have also been implicated in genotoxicity; thus, we explored a cell line model of the human bone marrow (BM) to secrete myeloid cytokines following drug treatment and their potential to induce micronuclei. HS-5 human stromal cells were exposed to mitoxantrone (MTX) and chlorambucil (CHL) and, for the first time, were profiled for 80 cytokines using an array. Fifty-four cytokines were detected in untreated cells, of which 24 were upregulated and 10 were downregulated by both drugs. FGF-7 was the lowest cytokine to be detected in both untreated and treated cells. Eleven cytokines not detected at baseline were detected following drug exposure. TNFα, IL6, GM-CSF, G-CSF, and TGFβ1 were selected for micronuclei induction. TK6 cells were exposed to these cytokines in isolation and in paired combinations. Only TNFα and TGFβ1 induced micronuclei at healthy concentrations, but all five cytokines induced micronuclei at storm levels, which was further increased when combined in pairs. Of particular concern was that some combinations induced micronuclei at levels above the mitomycin C positive control; however, most combinations were less than the sum of micronuclei induced following exposure to each cytokine in isolation. These data infer a possible role for cytokines through chemotherapy-induced cytokine storm, in the instigation and support of leukaemogenesis in the BM, and implicate the need to evaluate individuals for variability in cytokine secretion as a potential risk factor for complications such as DCL.
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Affiliation(s)
- Harshini S H Asurappulige
- School of Applied Sciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Adam D Thomas
- School of Applied Sciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - H Ruth Morse
- School of Applied Sciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
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7
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Jeong D, Gu JY, Seo MS, Lee JS, Chang YH, Seong MW, Yoon SS, Kim HK. A case of donor cell leukemia driven by a de novo NRAS mutation with complex karyotype. Ann Hematol 2023:10.1007/s00277-023-05291-6. [PMID: 37256306 DOI: 10.1007/s00277-023-05291-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/20/2023] [Indexed: 06/01/2023]
Affiliation(s)
- Dajeong Jeong
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Ja-Yoon Gu
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Myoung-Seock Seo
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jee-Soo Lee
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yoon Hwan Chang
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Moon-Woo Seong
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sung-Soo Yoon
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyun Kyung Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea.
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
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8
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O’Connor TE, Shaw R, Madero-Marroquin R, Roloff GW. Clinical considerations at the intersection of hematopoietic cell transplantation and hereditary hematopoietic malignancy. Front Oncol 2023; 13:1180439. [PMID: 37251919 PMCID: PMC10213438 DOI: 10.3389/fonc.2023.1180439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/28/2023] [Indexed: 05/31/2023] Open
Abstract
In recent years, advances in genetics and the integration of clinical-grade next-generation sequencing (NGS) assays into patient care have facilitated broader recognition of hereditary hematopoietic malignancy (HHM) among clinicians, in addition to the identification and characterization of novel HHM syndromes. Studies on genetic risk distribution within affected families and unique considerations of HHM biology represent exciting areas of translational research. More recently, data are now emerging pertaining to unique aspects of clinical management of malignancies arising in the context of pathogenic germline mutations, with particular emphasis on chemotherapy responsiveness. In this article, we explore considerations surrounding allogeneic transplantation in the context of HHMs. We review pre- and post-transplant patient implications, including genetic testing donor selection and donor-derived malignancies. Additionally, we consider the limited data that exist regarding the use of transplantation in HHMs and safeguards that might be pursued to mitigate transplant-related toxicities.
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Affiliation(s)
- Timothy E. O’Connor
- Department of Medicine, Loyola University Medical Center, Maywood, IL, United States
| | - Reid Shaw
- Department of Medicine, Loyola University Medical Center, Maywood, IL, United States
| | | | - Gregory W. Roloff
- Section of Hematology/Oncology, The University of Chicago, Chicago, IL, United States
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9
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Imamura M. Hypothesis: can transfer of primary neoplasm-derived extracellular vesicles and mitochondria contribute to the development of donor cell-derived hematologic neoplasms after allogeneic hematopoietic cell transplantation? Cytotherapy 2022; 24:1169-1180. [PMID: 36058790 DOI: 10.1016/j.jcyt.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 07/06/2022] [Accepted: 07/13/2022] [Indexed: 01/31/2023]
Abstract
Allogeneic hematopoietic cell transplantation (allo-HCT) is an essential treatment option for various neoplastic and non-neoplastic hematologic diseases. Although its efficacy is modest, a significant proportion of patients experience relapse, graft-versus-host disease, infection or impaired hematopoiesis. Among these, the most frequent cause of post-transplant mortality is relapse, whereas the development of de novo hematologic neoplasms from donor cells after allo-HCT occurs on some occasion as a rare complication. The mechanisms involved in the pathogenesis of the de novo hematologic neoplasms from donor cells are complex, and a multifactorial process contributes to the development of this complication. Recently, extracellular vesicles, particularly exosomes, and mitochondria have been shown to play crucial roles in intercellular communication through the transfer of specific constituents, such as deoxyribonucleic acids, ribonucleic acids, lipids, metabolites and cytosolic and cell-surface proteins. Here, I discuss the potential causative roles of these subcellular components in the development of de novo hematologic neoplasms from donor cells after allo-HCT, in addition to other etiologies.
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Affiliation(s)
- Masahiro Imamura
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan.
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10
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Applications of bile acids as biomaterials-based modulators, in biomedical science and microfluidics. Ther Deliv 2022; 13:591-604. [PMID: 36861306 DOI: 10.4155/tde-2022-0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Chronic disorders such as diabetes mellitus are associated with multiple organ dysfunction, including retinopathy, neuropathy, nephropathy, peripheral vascular disease, and vascular disease. Lifelong subcutaneous insulin injections are currently the only treatment option for patients with Type 1 diabetes mellitus, and it poses numerous challenges. Since the breakthrough achieved from the Edmonton protocol in the year 2000, there has been important research to investigate whether islet cell transplantation can achieve long-term normoglycemia in patients without the need for insulin. The use of biopolymeric scaffold to enclose islet cells has also been explored to improve survivability and viability of islet cells. This review paper summarizes the latest research in using biopolymeric scaffolds in islet transplantation and how microfluidic devices can assist.
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11
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Salence BK, Turner GDH, Stonard C, Peniket A, Danby R, Matin RN. Pruritic rash following haploidentical stem cell transplantation. Clin Exp Dermatol 2022; 47:1617-1621. [PMID: 35661395 DOI: 10.1111/ced.15230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2022] [Indexed: 11/29/2022]
Abstract
A woman who had undergone haematopoietic stem cell transplantation presented with cutaneous features suggestive of graft-versus-host disease. Histopathological examination revealed a diffuse dermal infiltration of atypical monomorphic cells with a high proliferative index. Immunohistochemistry revealed positivity for monocytic markers, but negativity for T-cell markers.
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Affiliation(s)
- Brogan Kelly Salence
- Department of Dermatology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Gareth D H Turner
- Department of Cellular Pathology, John Radcliffe Hospital, Oxford, UK
| | | | - Andrew Peniket
- Department of Haematology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Robert Danby
- Department of Haematology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Rubeta N Matin
- Department of Dermatology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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12
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J C, Am K, R S, Morris G, P B, Md S, Ds A. Systematic scoping review of studies reporting unexpected donor-derived abnormalities from recipients of allogeneic hematopoietic cell transplantation: a proposed framework for donor disclosure: donor-derived abnormalities in allogeneic HCT. Transplant Cell Ther 2022; 28:408.e1-408.e8. [PMID: 35398578 DOI: 10.1016/j.jtct.2022.03.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Allogeneic hematopoietic cell transplantation (HCT) is used increasingly to treat blood and immune-based disorders. Post-transplant testing of HCT recipients can lead to unexpected molecular, cytogenetic and other information in donor-derived cells, evoking questions regarding the potential impact on donor health. OBJECTIVE To identify the breadth of donor-derived abnormalities identified by testing HCT recipients and the extent to which disclosure and donor follow up are described. METHODS A systematic search and scoping review were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews in OVID MEDLINE and EMBASE (1947 to May 24, 2021). RESULTS We identified 38 studies (63 donor-recipient pairs) addressing non-leukemic abnormalities, to complement existing literature describing donor cell leukemia and donor-derived myelodysplasia. Donors were unrelated adults (n=20), related family members (n=28), cord blood donors (n=6) or were not reported (n=9). Acquired cytogenetic, molecular, and morphologic abnormalities were reported. Donor origin was confirmed by cytogenetic analysis via karyotyping, FISH, STR-PCR, and other techniques. A disease in donor-derived cells was described in 35 recipients (56.5%). Despite the relevance for testing and disclosure to donors, only 22 cases (32%) mentioned donor follow-up, and 5 cases confirmed that the donor developed a disease associated with the identified abnormality. Unrelated donor disclosure was mentioned in 3 of 26 cases (12%), where the findings were reported back to the registry. CONCLUSION Incidental abnormalities identified in transplanted donor cells may contribute to post-transplant risk of illness in the recipient and may be relevant to donor health. A framework for donor disclosure is proposed that incorporates consideration of analytic validity of the testing, potential significance of the finding, and the extent to which the abnormality is actionable. Adoption of effective processes to safeguard both donor and recipient health outcomes related to this issue is needed. [295].
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Affiliation(s)
- Candeliere J
- Stem Cells, Canadian Blood Services, Ottawa; Faculty of Medicine, University of Ottawa
| | - Kirkham Am
- Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute
| | - Shorr R
- Medical Library and Learning Services
| | | | - Berardi P
- Faculty of Medicine, University of Ottawa
| | - Seftel Md
- Stem Cells, Canadian Blood Services, Ottawa; Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Allan Ds
- Stem Cells, Canadian Blood Services, Ottawa; Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute; Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.
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13
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Aldoss I, Clark M, Marcucci G, Forman SJ. Donor derived leukemia in allogeneic transplantation. Leuk Lymphoma 2021; 62:2823-2830. [PMID: 34713775 DOI: 10.1080/10428194.2021.1929966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Allogeneic hematopoietic cell transplantation (alloHCT) is a curative option for the treatment of eligible patients with hematological malignancies. This modality confers a risk for life-threatening complications, including the rare and underdiagnosed complication of donor-derived leukemia (DDL). DDL differs from relapse of the original malignancy in that DDL originates from the donor stem cells and is unrelated to the original diagnosis. Because DDL may be the same lineage as the original diagnosis, it is difficult to identify these cases and many remain unrecognized. There is no consensus of how to approach the treatment of patients with DDL, and their prognosis is poor considering that patients with DDL have already been treated for their original leukemia and have undergone alloHCT. DDL occurs following transplants using any donor stem cell source (bone marrow, peripheral blood and cord blood) and any donor type (matched/unmatched, related/unrelated and haploidentical). Both donor and recipient factors contribute to the development of DDL, and a better understanding of these factors is crucial to reduce the risk for the development of DDL. In this review, we provide an overview of DDL, including the incidence, diagnosis, etiology, prognosis, and treatment.
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Affiliation(s)
- Ibrahim Aldoss
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA
| | - Mary Clark
- Department of Clinical and Translational Project Development, City of Hope, Duarte, CA, USA
| | - Guido Marcucci
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope, Duarte, CA, USA
| | - Stephen J Forman
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA
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14
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Musiu P, Quattrocchi L, Barberi W, Della Starza I, Elia L, De Novi LA, Petrucci L, De Luca G, Di Rocco A, La Rocca U. Donor cell derived mantle cell lymphoma in a HSCT sibling donor-recipient pair: intrinsic biological clock in lymphomagenesis. Leuk Lymphoma 2021; 63:499-502. [PMID: 34693859 DOI: 10.1080/10428194.2021.1984456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Paolo Musiu
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Luisa Quattrocchi
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Walter Barberi
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Irene Della Starza
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Loredana Elia
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Lucia Anna De Novi
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Luigi Petrucci
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Giulia De Luca
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Alice Di Rocco
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Ursula La Rocca
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
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15
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Zhang S, Li L, Cao W, Li Y, Jiang Z, Yu J, Wan D. Donor cell leukemia/myelodysplastic syndrome after allogeneic stem cell transplantation: a rare phenomenon with more challenges for hematologists. ACTA ACUST UNITED AC 2021; 26:648-651. [PMID: 34474660 DOI: 10.1080/16078454.2021.1966224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Donor cell leukemia (DCL) or Donor cell myelodysplastic syndrome (DC-MDS) is a rare type of leukemia or MDS and originates from the donor cells. It has very low frequency, but it seems to be steadily increasing as the physiopathology and mechanisms remain largely unknown. Here we report one case of acute lymphocytic leukemia (ALL) and one case of MDS of donor origin after allogeneic hematopoietic stem cell transplantation (HSCT). We also collated and reviewed literatures regarding DCL, and discuss the morbidity of DCL, the methods used to confirm donor origin and the etiology and pathogenesis of DCL. A new proposed theory will help us to better understand the mechanism for the oncogenesis of DCL.
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Affiliation(s)
- Suping Zhang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Li Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Weijie Cao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yingmei Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Zhongxing Jiang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Jifeng Yu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.,Academy of Medical and Pharmaceutical Sciences of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Dingming Wan
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
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16
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Williams L, Doucette K, Karp JE, Lai C. Genetics of donor cell leukemia in acute myelogenous leukemia and myelodysplastic syndrome. Bone Marrow Transplant 2021; 56:1535-1549. [PMID: 33686252 DOI: 10.1038/s41409-021-01214-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/21/2020] [Accepted: 01/07/2021] [Indexed: 01/31/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) is an important therapeutic modality for patients with acute myelogenous leukemia (AML) with poor risk features. Nonetheless, roughly 30% of such patients have leukemia recurrence and up to 2% of these are donor-derived leukemias, in which malignancy develops in the donor's transplanted cells, despite extremely low rates of leukemia in the donors themselves. Notably, over 20% of these malignancies carry chromosome 7 abnormalities nearly all of which are monosomies. Recent advances in whole exome and genome sequencing have allowed for detection of candidate genes that likely contribute to the development of AML in donor cells (donor leukemia, DCL). These genes include CEBPA, GATA2, JAK2, RUNX1, DDX41, EZH2, IDH1/2, DNMT3A, ASXL1, XPD, XRCC3, and CHEK1. The potential roles of variants in these genes are evaluated based on familial clustering of MDS/AML and corresponding animal studies demonstrating their leukemogenic nature. This review describes the spectrum of genetic aberrations detected in DCL cases in the literature with regard to the character of the individual cases, existing family cohorts that carry individual genes, and functional studies that support etiologic roles in AML development. DCL presents a unique opportunity to examine genetic variants in the donors and recipients with regards to progression to malignancy.
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Affiliation(s)
- Lacey Williams
- Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Kimberley Doucette
- Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Judith E Karp
- The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Catherine Lai
- Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC, USA.
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17
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Burns SS, Kapur R. Clonal Hematopoiesis of Indeterminate Potential as a Novel Risk Factor for Donor-Derived Leukemia. Stem Cell Reports 2021; 15:279-291. [PMID: 32783925 PMCID: PMC7419737 DOI: 10.1016/j.stemcr.2020.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/22/2022] Open
Abstract
Hematopoietic stem cell transplantation (HSCT) is a critical treatment modality for many hematological and non-hematological diseases that is being extended to treat older individuals. However, recent studies show that clonal hematopoiesis of indeterminate potential (CHIP), a common, asymptomatic condition characterized by the expansion of age-acquired somatic mutations in blood cell lineages, may be a risk factor for the development of donor-derived leukemia (DDL), unexplained cytopenias, and chronic graft-versus-host disease. CHIP may contribute to the pathogenesis of these significant transplant complications via various cell-autonomous and non-cell-autonomous mechanisms, and the clinical presentation of DDL may be broader than anticipated. A more comprehensive understanding of the contributions of CHIP to DDL may have important implications for the screening of donors and will improve the safety of HSCT. The objective of this review is to discuss studies linking DDL and CHIP and to explore potential mechanisms by which CHIP may contribute to DDL.
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Affiliation(s)
- Sarah S Burns
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Department of Pediatrics, Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Reuben Kapur
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Department of Pediatrics, Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Department of Molecular Biology and Biochemistry, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
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18
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Hagiwara S, Kusumoto S, Ito A, Masaki A, Shiraga K, Tachita T, Hirade K, Oiwa K, Suzuki T, Kinoshita S, Ri M, Ito Y, Komatsu H, Inagaki H, Iida S. Volunteer unrelated donor cell‐derived acute myeloid leukemia with
RUNX1‐RUNX1T1. EJHAEM 2021; 2:285-290. [PMID: 35845276 PMCID: PMC9175994 DOI: 10.1002/jha2.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/19/2021] [Indexed: 11/28/2022]
Abstract
A 15‐year‐old male was diagnosed with acute myeloid leukemia with t(6;9)(p23;q34), a chimeric DEK‐NUP214 fusion gene. He underwent allogeneic bone marrow transplantation (allo‐BMT) from an unrelated volunteer donor at first molecular remission. Approximately 5 years after allo‐BMT, multiple bone marrow aspirations showed increased blasts to 63%, which were positive for myeloperoxidase, CD13, CD33, CD56, and CD34. Surprisingly, t(8;21)(q22;q22.1), a chimeric RUNX1‐RUNX1T1 (not DEK‐NUP214) fusion gene, was detected with full donor chimerism. To our best knowledge, this is the first case of a volunteer unrelated donor cell‐derived acute myeloid leukemia harboring a chimeric RUNX1‐RUNX1T1 fusion gene.
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Affiliation(s)
- Shinya Hagiwara
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Shigeru Kusumoto
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Asahi Ito
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Ayako Masaki
- Department of Pathology and Molecular Diagnostics Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Kazuhide Shiraga
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Takuto Tachita
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
- Department of Gastroenterology and Hematology Hirosaki University Graduate School of Medicine Hirosaki Japan
| | - Kentaro Hirade
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Kana Oiwa
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Tomotaka Suzuki
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Shiori Kinoshita
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Masaki Ri
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Yasuhiko Ito
- Department of Pediatrics and Neonatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
- Nagoya City West Medical Center Pediatrics Nagoya Japan
| | - Hirokazu Komatsu
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Hiroshi Inagaki
- Department of Pathology and Molecular Diagnostics Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
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19
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Malignant progression of donor-engrafted clonal hematopoiesis in sibling recipients after stem cell transplantation. Blood Adv 2020; 4:5631-5634. [PMID: 33186460 DOI: 10.1182/bloodadvances.2020003168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/16/2020] [Indexed: 11/20/2022] Open
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20
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Suárez-González J, Triviño JC, Bautista G, García-Marco JA, Figuera Á, Balas A, Vicario JL, Ortuño FJ, Teruel R, María Álamo J, Carbonell D, Andrés-Zayas C, Dorado N, Rodríguez-Macías G, Kwon M, Díez-Martín JL, Martínez-Laperche C, Buño I, Spanish Group For Hematopoietic Transplantation Geth. Exome sequencing reveals heterogeneous clonal dynamics in donor cell myeloid neoplasms after stem cell transplantation. Haematologica 2020; 105:2655-2658. [PMID: 33131255 PMCID: PMC7604628 DOI: 10.3324/haematol.2019.234609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Julia Suárez-González
- Genomics Unit, Gregorio Maranon G. U. Hospital and Health Research Institute (IiSGM), Madrid, Spain
| | | | - Guiomar Bautista
- Department of Hematology, Puerta de Hierro General University Hospital, Madrid, Spain
| | | | - Ángela Figuera
- Department of Hematology, La Princesa University Hospital, Madrid, Spain
| | - Antonio Balas
- Department of Histocompatibility, Madrid Blood Centre, Spain
| | | | - Francisco José Ortuño
- Dept of Hematology-Medical Oncology, IMIB-Arrixaca, Morales Meseguer G. U. Hospital, Murcia, Spain
| | - Raúl Teruel
- Dept of Hematology-Medical Oncology, IMIB-Arrixaca, Morales Meseguer G. U. Hospital, Murcia, Spain
| | | | - Diego Carbonell
- IiSGM and Dept. of Hematology, Gregorio Maranon General University Hospital, Madrid, Spain
| | - Cristina Andrés-Zayas
- Genomics Unit, Gregorio Maranon G. U. Hospital and Health Research Institute (IiSGM), Madrid, Spain
| | - Nieves Dorado
- IiSGM and Dept of Hematology, Gregorio Maranon G. U. Hospital, Madrid, Spain
| | | | - Mi Kwon
- IiSGM and Dept of Hematology, Gregorio Maranon G. U. Hospital, Madrid, Spain
| | - José Luis Díez-Martín
- IiSGM, Gregorio Maranon G. U. Hospital and Complutense University of Madrid, Madrid, Spain
| | | | - Ismael Buño
- IiSGM, Gregorio Maranon G. U. Hospital and Complutense University of Madrid, Madrid, Spain
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21
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Navarro-Bailón A, Carbonell D, Escudero A, Chicano M, Muñiz P, Suárez-González J, Bailén R, Oarbeascoa G, Kwon M, Díez-Martín JL, Martínez-Laperche C, Buño I. Short Tandem Repeats (STRs) as Biomarkers for the Quantitative Follow-Up of Chimerism after Stem Cell Transplantation: Methodological Considerations and Clinical Application. Genes (Basel) 2020; 11:genes11090993. [PMID: 32854376 PMCID: PMC7565503 DOI: 10.3390/genes11090993] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/19/2020] [Accepted: 08/23/2020] [Indexed: 01/06/2023] Open
Abstract
Chimerism refers to the relative proportion of donor and recipient DNA after hematopoietic stem cell transplantation (HSCT) and its quantitative follow-up is of great clinical utility in this setting. PCR of short tandem repeats (STR-PCR) constitutes the gold standard method for chimerism quantification, although more sensitive PCR techniques (such as qPCR) have recently arisen. We compared the sensitivity and the quantification capacity of both techniques in patient samples and artificial mixtures and demonstrated adequate performance of both methods, with higher sensitivity of qPCR and better quantification skills of STR-PCR. By qPCR, we then prospectively followed up 57 patients that were in complete chimerism (CC) by STR-PCR. Twenty-seven patients (59%) showed 0.1–1% recipient DNA in the bone marrow. Only 4 patients presented 0.1–1% recipient DNA in peripheral blood (PB), and one of them relapsed. Finally, by qPCR, we retrospectively studied the last sample that showed CC by STR-PCR prior to relapse in 8 relapsed patients. At a median of 59 days prior to relapse, six patients presented mixed chimerism by qPCR in PB. Since both approaches have complementary characteristics, we conclude that different techniques should be applied in different clinical settings and therefore propose a methodological algorithm for chimerism follow-up after HSCT.
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Affiliation(s)
- Almudena Navarro-Bailón
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
| | - Diego Carbonell
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - Asunción Escudero
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
| | - María Chicano
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - Paula Muñiz
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - Julia Suárez-González
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
- Genomics Unit, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Rebeca Bailén
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - Gillen Oarbeascoa
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - Mi Kwon
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - José Luis Díez-Martín
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
- Department of Medicine, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Carolina Martínez-Laperche
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
- Genomics Unit, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Ismael Buño
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
- Genomics Unit, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Department of Cell Biology, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Correspondence: ; Tel.: +91-5868775
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22
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Nakaya Y, Nakao T, Ueda Y, Takamori H, Nishimura JI, Tatsumi N, Tsutsumi M, Yoshida M, Yoshimura T, Hayashi Y, Yamane T. Donor stem cell-derived paroxysmal nocturnal hemoglobinuria after umbilical cord blood transplantation. Eur J Haematol 2020; 105:659-661. [PMID: 32716556 DOI: 10.1111/ejh.13498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/21/2020] [Indexed: 11/29/2022]
Abstract
Donor cell-derived hematological disorder (DCHD) is a rare complication of allogeneic hematopoietic stem cell transplantation (HSCT). The number of reports of DCHD has been increasing in the last decade, which likely reflects the growing number of HSCTs and the improved ability to identify the donor cell origin. Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired hematological disorder arising in the context of clonal expansion of hematopoietic stem cells harboring a somatic mutation in phosphatidylinositol glycan anchor biosynthesis, class A. We report here a patient with adult T-cell leukemia/lymphoma, who developed PNH 7 years after umbilical cord blood transplantation. The patient has maintained complete remission with full-donor chimerism after HSCT. Thus, PNH was derived from stem cells of donor origin. The immature immune environment in the recipient after cord blood transplantation might have contributed to the rapid clonal expansion for neonatal stem cells in cord blood to develop typical symptomatic PNH in a short period. To the best of our knowledge, this is the first report in the literature of a case of PNH that developed in donor stem cells after HSCT.
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Affiliation(s)
- Yosuke Nakaya
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Takafumi Nakao
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Yasutaka Ueda
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroyuki Takamori
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Jun-Ichi Nishimura
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naoko Tatsumi
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Minako Tsutsumi
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Masahiro Yoshida
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Takuro Yoshimura
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Yoshiki Hayashi
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Takahisa Yamane
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
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23
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Kondo T, Tasaka T, Shimizu R, Hayashi K, Yamada S, Fukuda H, Hirose T, Takeuchi A, Sano F, Tokunaga H, Matsuhashi Y, Wada H. Jumping translocations of 1q in donor cell-derived myelodysplastic syndrome after cord blood transplantation: Case report and review of the literature. Mol Clin Oncol 2020; 12:365-373. [PMID: 32190321 DOI: 10.3892/mco.2020.1995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 07/03/2019] [Indexed: 11/06/2022] Open
Abstract
Donor cell-derived leukemia and myelodysplastic syndrome (DCL) is a rare complication in patients after allogenic stem cell transplantation (SCT). Since 1971, numerous cases of DCL have been reported, but the detailed mechanisms of DCL are still unclear. A patient with jumping translocations (JTs) of 1q in umbilical cord blood donor cell-derived myelodysplastic syndrome (MDS), which likely occurred due to genetic alterations of TET2 and ASXL1 after cord blood transplantation (CBT), was examined in this study. Previously reported DCL cases after CBT that focused on the cytogenetic and molecular characteristics of these patients and patient outcome were reviewed. A total of 30 cases of DCL after CBT were identified between 2005 and 2018. The median time from CBT to the development of DCL was 16 months. The number of patients with DCL who were diagnosed with acute myeloid leukemia (AML) and MDS was 19 and 8, respectively. JTs were frequently observed in 5 of 27 DCL patients who had cytogenetic abnormalities, including our patient. Molecular abnormalities were described in 7 of the cases, and the most frequent abnormality was an NPM1 mutation. Other gene mutations that were usually found in de novo MDS or AML were observed in JT-DCL after CBT. From these results, chromosomal abnormalities such as JTs that occur subsequent to genetic alterations were seemed an important mechanisms underlying DCL onset in patients after CBT. Further molecular analyses regarding the genetic alterations of JTs are required to understand the pathogenesis of umbilical cord blood-derived JT-DCL.
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Affiliation(s)
- Toshinori Kondo
- Department of Hematology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan
| | - Taizo Tasaka
- Department of Transfusion Medicine and Cell Therapy, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama 350-8550, Japan
| | - Risa Shimizu
- Department of Hematology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan
| | - Kiyohito Hayashi
- Department of Hematology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan
| | - Seiko Yamada
- Department of Hematology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan
| | - Hirofumi Fukuda
- Department of Hematology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan
| | - Tadashi Hirose
- Department of Hematology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan
| | - Asako Takeuchi
- Department of Hematology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan
| | - Fuminori Sano
- Department of Hematology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan
| | - Hirotoshi Tokunaga
- Department of Hematology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan
| | - Yoshiko Matsuhashi
- Department of Hematology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan
| | - Hideho Wada
- Department of Hematology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan
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24
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Bouvier A, Ribourtout B, François S, Orvain C, Paz DL, Beucher A, Guérard A, Guardiola P, Ugo V, Blanchet O, Geneviève F, Schmidt A, Hunault-Berger M. Donor cell-derived acute promyelocytic leukemia after allogeneic hematopoietic stem cell transplantation. Eur J Haematol 2018; 101:570-574. [PMID: 30007088 DOI: 10.1111/ejh.13143] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/06/2018] [Accepted: 07/06/2018] [Indexed: 12/21/2022]
Abstract
Donor cell leukemia (DCL) is an infrequent complication after allogeneic hematopoietic stem cell transplantation (HSCT). Its true incidence is difficult to assess, although improvements in chimerism studies contributed to a better diagnosis of DCL. We report two rare cases of donor cell-derived acute promyelocytic leukemia (APL). To our knowledge, only two cases have been described in the literature. Here, we report one male and one female patients with acute myeloid leukemia (AML), who developed an APL in donor cells after HSCT. The latency between HSCT and DCL was 279 and 43 months, respectively. Fluorescent in situ hybridation and chimerism monitoring analysis proved the donor origin of APL. Surprisingly, donor lymphocyte infusion provided a hematological response during 19 months in the female patient. The mechanisms associated with pathogenesis of DCL are unclear and seem to be multifactorial. Increasing worldwide allogeneic hematopoietic stem cell transplantation activity and potentially the age of donor could explain the increasing incidence of DCL in the future. It is highlighted that long-term follow up of recipients will allow to report all cases of DCL, to clarify the genetic landscape and factors which contribute to DCL, to understand the response to DLI.
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Affiliation(s)
- Anne Bouvier
- Laboratoire d'Hématologie, CHU d'Angers, Angers, France.,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Bénédicte Ribourtout
- Laboratoire d'Hématologie, CHU d'Angers, Angers, France.,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France
| | - Sylvie François
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,Service des maladies du sang, CHU d'Angers, Angers, France
| | - Corentin Orvain
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Service des maladies du sang, CHU d'Angers, Angers, France.,UFR Santé, Université d'Angers, Angers, France
| | - Damien Luque Paz
- Laboratoire d'Hématologie, CHU d'Angers, Angers, France.,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,UFR Santé, Université d'Angers, Angers, France
| | - Annaëlle Beucher
- Laboratoire d'Hématologie, CHU d'Angers, Angers, France.,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France
| | - Alexandre Guérard
- Laboratoire d'Hématologie, CHU d'Angers, Angers, France.,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,UFR Santé, Université d'Angers, Angers, France
| | - Philippe Guardiola
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Service des maladies du sang, CHU d'Angers, Angers, France.,UFR Santé, Université d'Angers, Angers, France.,Service de Génomique Onco-Hématologique, CHU Angers, Angers, France
| | - Valérie Ugo
- Laboratoire d'Hématologie, CHU d'Angers, Angers, France.,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,UFR Santé, Université d'Angers, Angers, France
| | - Odile Blanchet
- Laboratoire d'Hématologie, CHU d'Angers, Angers, France.,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,UFR Santé, Université d'Angers, Angers, France.,Centre de ressources biologiques, CHU Angers, Angers, France
| | - Franck Geneviève
- Laboratoire d'Hématologie, CHU d'Angers, Angers, France.,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France
| | - Aline Schmidt
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Service des maladies du sang, CHU d'Angers, Angers, France.,UFR Santé, Université d'Angers, Angers, France
| | - Mathilde Hunault-Berger
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Service des maladies du sang, CHU d'Angers, Angers, France.,UFR Santé, Université d'Angers, Angers, France
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