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Bejarano L, Sayagués JM, Alcoceba M, Balanzategui A, Lopez-Corral L, Cañueto J, Santos-Briz A. Primary Cutaneous Marginal Zone Lymphoproliferative Disorder of Donor Origin after Allogeneic Hematopoietic Stem Cell Transplantation. Am J Dermatopathol 2023; 45:378-382. [PMID: 37130208 DOI: 10.1097/dad.0000000000002439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
ABSTRACT Primary cutaneous posttransplant lymphoproliferative disorders (PTLDs) after allogeneic hematopoietic stem cell transplant (allo-HSCT) are exceedingly rare, with only 6 published cases, all of them consisting in T-cell neoplasms. In this report, we present for the first time a donor-derived B-cell PTLD consisting in a primary, cutaneous, B-cell, marginal zone, lymphoproliferative disorder (PCMZLPD). The patient, a 37-year-old woman with a history of Hodgkin lymphoma received an allo-HSCT from her healthy, matched, related father, achieving complete host chimerism in the bone marrow and peripheral blood. However, 8 years after the allo-HSCT, she presented asymptomatic skin lesions consisting in oval, well-defined, slightly raised erythematous plaques, located on the arms, trunk, and legs. Skin biopsies of 2 lesions demonstrated a class-switched IgG+, EBV-, PCMZLPD, showing kappa light chain restriction and monoclonal rearrangement of the IgH gene. Microsatellite genotyping and 2-color fluorescence in situ hybridization (X and Y chromosomes) confirmed that the origin of the neoplastic cells was the donor graft. The lesions showed an indolent behavior, good response to topical corticosteroids, and no need for systemic treatment. Our case broadens the spectrum of PTLD, a diverse group of lymphoid and/or plasmacytic proliferations with variable clinical presentations and histopathological features.
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Affiliation(s)
- Lía Bejarano
- Service of Dermatology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Jose María Sayagués
- Department of Pathology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
- Institute for Biomedical Research (IBSAL), Salamanca, Spain
| | - Miguel Alcoceba
- Institute for Biomedical Research (IBSAL), Salamanca, Spain
- Department of Haematology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain; and
- Cancer Research Centre-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Ana Balanzategui
- Institute for Biomedical Research (IBSAL), Salamanca, Spain
- Department of Haematology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain; and
- Cancer Research Centre-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Lucia Lopez-Corral
- Institute for Biomedical Research (IBSAL), Salamanca, Spain
- Department of Haematology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain; and
- Cancer Research Centre-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Javier Cañueto
- Service of Dermatology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
- Institute for Biomedical Research (IBSAL), Salamanca, Spain
| | - Angel Santos-Briz
- Department of Pathology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
- Institute for Biomedical Research (IBSAL), Salamanca, Spain
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Mehta R, Torres Cabala CA, DiNardo CD, Daver N, Dabaja B, Rezvani K, Champlin RE, Shpall E, Duvic M. Post-transplantation donor-derived Sezary syndrome in a patient with A91V PRF1 variant hemophagocytic lymphohistiocytosis. Am J Hematol 2021; 96:E350-E353. [PMID: 34096089 DOI: 10.1002/ajh.26266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 01/25/2023]
Affiliation(s)
- Rohtesh Mehta
- Department of Stem Cell Transplantation and Cellular Therapy The University of Texas MD Anderson Cancer Center Houston Texas USA
| | | | - Courtney D. DiNardo
- Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Naval Daver
- Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Bouthaina Dabaja
- Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Katy Rezvani
- Department of Stem Cell Transplantation and Cellular Therapy The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Richard E. Champlin
- Department of Stem Cell Transplantation and Cellular Therapy The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Elizabeth Shpall
- Department of Stem Cell Transplantation and Cellular Therapy The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Madeleine Duvic
- Department of Dermatology The University of Texas MD Anderson Cancer Center Houston Texas USA
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Afiat TP, Zhang X, Zhang H, Ayala E, Zhang L, Sokol L. Sezary syndrome manifesting as posttransplant lymphoproliferative disorder. Leuk Res Rep 2018; 9:72-75. [PMID: 29761072 PMCID: PMC5948470 DOI: 10.1016/j.lrr.2018.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/17/2018] [Accepted: 04/30/2018] [Indexed: 11/08/2022] Open
Abstract
Posttransplant lymphoproliferative disorders (PTLDs) of T-cell orgin are rare biologically heterogeneous diseases of mature lymphoid cells manifesting in immunosuppressed patients. Only a few cases of mycosis fungoides diagnosed post allogeneic hematopoietic cell transplant (alloHSCT) have been described so far. We present a patient with myelodysplastic syndrome (MDS) post matched unrelated donor alloHSCT who was on long-term immunosuppressive therapy due to graft versus host disease. Three years after an alloHSCT, she developed generalized erythroderma and peripheral blood lymphocytosis. Both skin biopsy and peripheral blood flow cytometry revealed atypical CD4+ T-cell population consistent with diagnosis of Sezary syndrome. Chimerism studies revealed 100% donor engraftment. Therapy with extracorporeal photopheresis resulted in complete response in blood and skin.
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Affiliation(s)
- Thanh-Phuong Afiat
- Department of Internal Medicine, College of Medicine, University of South Florida, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
| | - Xiaohui Zhang
- Department of Hematopathology and Laboratory Medicine, Moffitt Cancer Center, Tampa, FL, USA
| | - Hailing Zhang
- Department of Hematopathology and Laboratory Medicine, Moffitt Cancer Center, Tampa, FL, USA
| | - Ernesto Ayala
- Department of Blood and Marrow Transplant, Moffitt Cancer Center, Tampa, FL, USA
| | - Ling Zhang
- Department of Hematopathology and Laboratory Medicine, Moffitt Cancer Center, Tampa, FL, USA
| | - Lubomir Sokol
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, USA
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Inversion 3 Cytogenetic Abnormality in an Allogeneic Hematopoietic Cell Transplant Recipient Representative of a Donor-Derived Constitutional Abnormality. Biol Blood Marrow Transplant 2017; 23:1582-1587. [PMID: 28549770 DOI: 10.1016/j.bbmt.2017.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/12/2017] [Indexed: 11/23/2022]
Abstract
Allogeneic hematopoietic cell transplantation (HCT) is an important treatment for many severe hematologic disorders; however, HCT can be associated with significant complications, including organ toxicity, graft-versus-host disease, and relapse. Another serious, but rare, complication is the transmission of hematologic and nonhematologic diseases from the donor to the recipient. With older donors, the risk of an abnormality may be increased. Here we describe the transmission of an inversion 3 constitutional cytogenetic abnormality from an unrelated donor to a recipient, and review the clinical implications of the discovery of donor-derived constitutional cytogenetic abnormalities.
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