1
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Díaz de la Pinta FJ, Manso R, Torre J, Requena L, Rodriguez-Pinilla SM. Recurrence of an erythrodermic mycosis fungoides as a biologically indolent anaplastic large T-cell lymphoma initially misdiagnosed as being of donor origin. J Cutan Pathol 2024. [PMID: 39177046 DOI: 10.1111/cup.14710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 07/26/2024] [Accepted: 08/13/2024] [Indexed: 08/24/2024]
Affiliation(s)
| | - Rebeca Manso
- Pathology Department, Hospital Universitario Fundación Jimenez Díaz, Madrid, Spain
| | - Juan Torre
- Dermatology Department, Hospital Universitario Fundación Jimenez Díaz, Madrid, Spain
| | - Luis Requena
- Dermatology Department, Hospital Universitario Fundación Jimenez Díaz, Madrid, Spain
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2
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Harro CM, Sprenger KB, Chaurio RA, Powers JJ, Innamarato P, Anadon CM, Zhang Y, Biswas S, Mandal G, Mine JA, Cortina C, Nagy MZ, Martin AL, Handley KF, Borjas GJ, Chen PL, Pinilla-Ibarz J, Sokol L, Yu X, Conejo-Garcia JR. Sézary syndrome originates from heavily mutated hematopoietic progenitors. Blood Adv 2023; 7:5586-5602. [PMID: 37531660 PMCID: PMC10514084 DOI: 10.1182/bloodadvances.2022008562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/04/2023] Open
Abstract
The pathogenesis of cutaneous T-cell lymphoma (CTCL) remains unclear. Using single-cell RNA or T-cell receptor (TCR) sequencing of 32 619 CD3+CD4+ and CD26+/CD7+ and 29 932 CD3+CD4+ and CD26-/CD7- lymphocytes from the peripheral blood of 7 patients with CTCL, coupled to single-cell ATAC-sequencing of 26,411 CD3+CD4+ and CD26+/CD7+ and 33 841 CD3+CD4+ and CD26-/CD7- lymphocytes, we show that tumor cells in Sézary syndrome and mycosis fungoides (MF) exhibit different phenotypes and trajectories of differentiation. When compared to MF, Sézary cells exhibit narrower repertoires of TCRs and exhibit clonal enrichment. Surprisingly, we identified ≥200 mutations in hematopoietic stem cells from multiple patients with Sézary syndrome. Mutations in key oncogenes were also present in peripheral Sézary cells, which also showed the hallmarks of recent thymic egression. Together our data suggest that CTCL arises from mutated lymphocyte progenitors that acquire TCRs in the thymus, which complete their malignant transformation in the periphery.
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Affiliation(s)
- Carly M. Harro
- Department of Immunology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
- Department of Cell Biology, Microbiology, and Molecular Biology, University of South Florida, Tampa, FL
- Cancer Biology PhD Program, College of Arts and Sciences, University of South Florida, Tampa, FL
| | - Kimberly B. Sprenger
- Department of Immunology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Ricardo A. Chaurio
- Department of Immunology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
- Department of Immunology, Duke School of Medicine, Durham, NC
| | - John J. Powers
- Department of Immunology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Patrick Innamarato
- Department of Immunology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Carmen M. Anadon
- Department of Immunology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
- Department of Immunology, Duke School of Medicine, Durham, NC
| | - Yumeng Zhang
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Subir Biswas
- Department of Immunology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Kharghar, Navi Mumbai, India
| | - Gunjan Mandal
- Department of Immunology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
- Department of Biotechnology, Institute of Life Sciences, Bhubaneswar, India
| | - Jessica A. Mine
- Department of Immunology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
- Department of Immunology, Duke School of Medicine, Durham, NC
| | - Carla Cortina
- Department of Immunology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Mate Z. Nagy
- Department of Immunology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Alexandra L. Martin
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Katelyn F. Handley
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Gustavo J. Borjas
- Department of Immunology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Pei-Ling Chen
- Department of Pathology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Javier Pinilla-Ibarz
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Lubomir Sokol
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Xiaoqing Yu
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Jose R. Conejo-Garcia
- Department of Immunology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
- Department of Immunology, Duke School of Medicine, Durham, NC
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
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3
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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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4
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Khattab A, Patruni S, Patrus G, Samhouri Y, Fazal S, Lister J. Donor Cell Leukemia Following Allogeneic Hematopoietic Stem Cell Transplantation. J Hematol 2023; 12:138-144. [PMID: 37435412 PMCID: PMC10332864 DOI: 10.14740/jh1124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 05/12/2023] [Indexed: 07/13/2023] Open
Abstract
Approximately 25,000 allogeneic transplants are performed annually worldwide; a figure that has steadily increased over the past three decades. The study of transplant recipient survivorship has become a cogent topic and post-transplant donor cell pathology warrants further study. Donor cell leukemia (DCL) is a rare but serious complication of allogeneic stem cell transplantation (SCT) where the recipient develops a form leukemia originating from the donor cells used for transplantation. Detection of abnormalities predicting donor cell pathology might inform donor selection, and the design of survivorship programs for early detection of these abnormalities might allow therapeutic intervention earlier in the disease course. We present four recipients of allogeneic hematopoietic stem cell transplant (HSCT) from our institution who developed donor cell abnormalities allogeneic SCT, highlighting their clinical characteristics and challenges.
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Affiliation(s)
- Ahmed Khattab
- Department of Medical Oncology and Hematology, Allegheny Health Network, Pittsburgh, PA, USA
- Division of Hematology and Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA 15212, USA
| | - Sunita Patruni
- Department of Medical Oncology and Hematology, Northwell Health, Lake Success, NY, USA
| | - Gina Patrus
- Division of Hematology and Cellular Therapy, Allegheny Health Network, Pittsburgh, PA, USA
| | - Yazan Samhouri
- Division of Hematology and Cellular Therapy, Allegheny Health Network, Pittsburgh, PA, USA
| | - Salman Fazal
- Division of Hematology and Cellular Therapy, Allegheny Health Network, Pittsburgh, PA, USA
| | - John Lister
- Division of Hematology and Cellular Therapy, Allegheny Health Network, Pittsburgh, PA, USA
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5
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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: 1] [Impact Index Per Article: 0.5] [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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6
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Lessons Learned from Donor Cell-Derived Myeloid Neoplasms: Report of Three Cases and Review of the Literature. Life (Basel) 2022; 12:life12040559. [PMID: 35455050 PMCID: PMC9028156 DOI: 10.3390/life12040559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/29/2022] [Accepted: 04/01/2022] [Indexed: 11/16/2022] Open
Abstract
Donor-cell derived myeloid neoplasm (DDMN), a rare complication after allogeneic hematopoietic cell transplantation (HCT), is of interest for its potential to reveal donor-derived and host-derived factors that contribute to the pathogenesis of leukemia. The accurate diagnosis of donor-derived leukemias has been facilitated by the more frequent use of molecular techniques. In this study, we describe three additional cases of DDMN; the first reported case of donor-derived chronic myelomonocytic leukemia (CMML), one acute myeloid leukemia (AML) with t(8;21)(q22;22); RUNX1-RUNX1T1 and one donor-derived MDS with deletion 5q. A review of the cytogenetic profiles of previously reported DDMN indicates a significant contribution of therapy-related myeloid neoplasms. Cases with direct evidence of donor- or recipient-dependent factors are rare; a role of direct transfer of leukemic cells, genomic instability of the donor, abnormal gene methylation in donor cells, proleukemic potential of abnormal stromal niche, and the role of immunological surveillance after transplantation has been observed. The role of additional potential pathogenetic factors that are without clinically observed evidence are also reviewed.
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7
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Clonotype pattern in T-cell lymphomas map the cell of origin to immature lymphoid precursors. Blood Adv 2022; 6:2334-2345. [PMID: 35015812 PMCID: PMC9006294 DOI: 10.1182/bloodadvances.2021005884] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/07/2021] [Indexed: 11/20/2022] Open
Abstract
Mature T-cell lymphomas (TCLs) are rare, clinically heterogeneous hematologic cancers of high medical need. TCLs have inferior prognosis which is attributed to poor understanding of their pathogenesis. Based on phenotypic similarities between normal and neoplastic lymphocytes it has been assumed that TCLs develop in the periphery, directly from various subtypes of normal T-cells. To address the debated question of the cell of origin in TCLs we analyzed to identify the highly variable complementarity determining regions (CDR3) regions of T-cell receptor (TCR) to trace the clonal history of the T-cells. We have collected previously published whole genome -exome, and -transcriptome sequencing data from 574 TCL patients. TCR clonotypes were identified by de novo assembly of CDR3 regions of TCR γ, β and α. We have found that the vast majority of TCLs are clonotypically oligoclonal, although the pattern oligoclonality varied. Anaplastic large cell lymphoma was most diverse comprising multiple clonotypes of TCRγ, β and α whereas adult T-cell lymphoma/leukemia and peripheral T-cell lymphomas often showed monoclonality for TCRγ and β but had diverse TCRα clonotypes. These patterns of rearrangements indicated that TCLs are initiated at the level of the lymphoid precursor. In keeping with this hypothesis, TCR rearrangements in TCLs resembled the pattern seen in the human thymus showing biased usage of V and J segments of high combinatorial probability resulting in recurrent, "public" CDR3 sequences shared across unrelated patients and different clinical TCL entities. Clonotypically diverse initiating cells may seed target tissues being responsible for disease relapses after therapy.
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8
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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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9
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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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10
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Prieto-Torres L, Trascasa Á, Manso R, Machan S, Cieza-Diaz D, Olmedilla G, García-García M, Ara-Martín M, Requena L, Piris MÁ, Rodríguez-Pinilla SM. Two independent consecutive lymphoma cases carry an identical MYD88 mutation but differ in their IGVH rearrangement. Br J Haematol 2020; 190:e352-e356. [PMID: 32578872 DOI: 10.1111/bjh.16917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
| | - Álvaro Trascasa
- Department of Pathology, Fundación Jimenez Diaz, Madrid, Spain
| | - Rebeca Manso
- Department of Pathology, Fundación Jimenez Diaz, Madrid, Spain
| | - Salma Machan
- Department of Dermatology, Fundación Jimenez Diaz, Madrid, Spain
| | - Deisy Cieza-Diaz
- Department of Dermatology, Fundación Jimenez Diaz, Madrid, Spain
| | - Gabriel Olmedilla
- Department of Pathology Hospital, Universitario La Paz, Madrid, Spain
| | - Mar García-García
- Department of Pathology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Mariano Ara-Martín
- Department of Dermatology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Luis Requena
- Department of Dermatology, Fundación Jimenez Diaz, Madrid, Spain
| | - Miguel Á Piris
- Department of Pathology, Fundación Jimenez Diaz, Madrid, Spain
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11
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Skin colonization by circulating neoplastic clones in cutaneous T-cell lymphoma. Blood 2020; 134:1517-1527. [PMID: 31515249 DOI: 10.1182/blood.2019002516] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 09/03/2019] [Indexed: 12/27/2022] Open
Abstract
Mycosis fungoides (MF) is a mature T-cell lymphoma currently thought to develop primarily in the skin by a clonal expansion of a transformed, resident memory T cell. However, this concept does not explain the key characteristics of MF, such as the debut with multiple, widespread skin lesions or inability of skin-directed therapies to provide cure. The testable inference of the mature T-cell theory is the clonality of MF with respect to all rearranged T-cell receptor (TCR) genes. Here, we used a whole-exome sequencing approach to detect and quantify TCR-α, β, and γ clonotypes in tumor cell clusters microdissected from MF lesions. This method allowed us to calculate the tumor cell fraction of the sample and therefore an unequivocal identification of the TCR clonotypes as neoplastic. Analysis of TCR sequences from 29 patients with MF stage I to IV proved the existence of multiple T-cell clones within the tumor cell fraction, with a considerable variation between patients and between lesions from the same patient (median, 11 clones; range, 2-80 clones/sample). We have also detected multiple neoplastic clones in the peripheral blood in all examined patients. Based on these findings, we propose that circulating neoplastic T-cell clones continuously replenish the lesions of MF, thus increasing their heterogeneity by a mechanism analogous to the consecutive tumor seeding. We hypothesize that circulating neoplastic clones might be a promising target for therapy and could be exploited as a potential biomarker in MF.
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12
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Araf S, Wang J, Ashton-Key M, Korfi K, Di Bella D, Rio-Machin A, Odabashian M, Foria V, Du MQ, Cucco F, Barrans S, Johnson P, Laird SR, Fisher AM, Cullis JO, Graham TA, Okosun J, Fitzgibbon J, Chiecchio L. Transmission of diffuse large B-cell lymphoma by an allogeneic stem-cell transplant. Haematologica 2019; 104:e174-e177. [PMID: 29976740 PMCID: PMC6442949 DOI: 10.3324/haematol.2018.196907] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
MESH Headings
- Adult
- Allografts
- Child
- Hematopoietic Stem Cell Transplantation
- Humans
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myeloid, Acute/therapy
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/etiology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/etiology
- Neoplasms, Second Primary/genetics
- Neoplasms, Second Primary/pathology
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Affiliation(s)
- Shamzah Araf
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London
| | - Jun Wang
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London
| | | | - Koorosh Korfi
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London
| | - Doriana Di Bella
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London
| | - Ana Rio-Machin
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London
| | - Mariette Odabashian
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London
| | - Vipul Foria
- University Hospital Southampton NHS Foundation Trust, Southampton
| | - Ming-Qing Du
- University of Cambridge, Cancer Research UK Centre
| | | | - Sharon Barrans
- Haematological Malignancy Diagnostic Service (HMDS), Leeds Cancer Centre
| | - Peter Johnson
- Univesity of Southampton, Cancer Sciences Unit, Cancer Research UK Centre
| | - Sophie R Laird
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury District Hospital
| | - Andrew M Fisher
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury District Hospital
| | - Jonathan O Cullis
- Haematology Department, Salisbury NHS Foundation Trust, Salisbury District Hospital
| | - Trevor A Graham
- Evolution and Cancer Laboratory, Barts Cancer Institute, Queen Mary University of London, UK
| | - Jessica Okosun
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London
| | - Jude Fitzgibbon
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London
| | - Laura Chiecchio
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury District Hospital
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13
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Hamrouni A, Fogh H, Zak Z, Ødum N, Gniadecki R. Clonotypic Diversity of the T-cell Receptor Corroborates the Immature Precursor Origin of Cutaneous T-cell Lymphoma. Clin Cancer Res 2019; 25:3104-3114. [PMID: 30808775 DOI: 10.1158/1078-0432.ccr-18-4099] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Mycosis fungoides is one of the most common types of extranodal T-cell lymphomas, considered to be caused by malignant transformation of the mature T cells residing in the skin. However, some clinical observations such as the multifocal distribution of mycosis fungoides lesions or patterns of relapse after radiotherapy are not readily explainable by the mature T-cell origin theory. EXPERIMENTAL DESIGN We have performed a detailed analysis of T-cell receptor (TCR) rearrangements in single malignant cells and in biopsies from mycosis fungoides tumors composed of >80% of malignant cells using next-generation sequencing (NGS) to pinpoint the relationship between neoplastic cells in mycosis fungoides. We have also aimed to detect malignant, circulating T-cell by whole blood TCR sequencing. RESULTS We found a substantial clonal heterogeneity in the mycosis fungoides samples with regards to TCR, and we demonstrated that lymphoma cells harboring identical TCRγ sequences may harbor different TCRα and β sequences. Lack of absolute TCRα, -β, -γ monoclonality was further confirmed by TCR amplification and sequencing from microdissected lymphoma cells. We have also found the TCR rearrangements characteristic for lymphoma cells in patients' peripheral blood despite the lack of leukemic blood involvement; however, the circulating TCRγ clonotype did not always represent the dominant cutaneous clonotype. CONCLUSIONS These findings can be explained by a model where malignant transformation takes place during early T-cell development giving rise to circulating premalignant clones, which home to the skin producing clinically apparent lesions of cutaneous lymphoma. Therapeutic strategies in T-cell lymphoma should therefore target those early lymphoma precursor cells.
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Affiliation(s)
- Abdelbasset Hamrouni
- Department of Dermatology and Venerology, Bispebjerg University Hospital, Copenhagen, Denmark.
| | - Hanne Fogh
- Department of Dermatology and Venerology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Zoulika Zak
- Division of Dermatology, Faculty of Medicine, University of Alberta, Edmonton, Canada
| | - Niels Ødum
- Department of International Health, Immunology, and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Robert Gniadecki
- Department of Dermatology and Venerology, Bispebjerg University Hospital, Copenhagen, Denmark.,Division of Dermatology, Faculty of Medicine, University of Alberta, Edmonton, Canada
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14
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Gayden T, Sepulveda FE, Khuong-Quang DA, Pratt J, Valera ET, Garrigue A, Kelso S, Sicheri F, Mikael LG, Hamel N, Bajic A, Dali R, Deshmukh S, Dervovic D, Schramek D, Guerin F, Taipale M, Nikbakht H, Majewski J, Moshous D, Charlebois J, Abish S, Bole-Feysot C, Nitschke P, Bader-Meunier B, Mitchell D, Thieblemont C, Battistella M, Gravel S, Nguyen VH, Conyers R, Diana JS, McCormack C, Prince HM, Besnard M, Blanche S, Ekert PG, Fraitag S, Foulkes WD, Fischer A, Neven B, Michonneau D, de Saint Basile G, Jabado N. Germline HAVCR2 mutations altering TIM-3 characterize subcutaneous panniculitis-like T cell lymphomas with hemophagocytic lymphohistiocytic syndrome. Nat Genet 2018; 50:1650-1657. [DOI: 10.1038/s41588-018-0251-4] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 09/05/2018] [Indexed: 12/14/2022]
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15
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Suárez-González J, Martínez-Laperche C, Kwon M, Balsalobre P, Carbonell D, Chicano M, Rodríguez-Macías G, Serrano D, Gayoso J, Díez-Martín JL, Buño I. Donor Cell-Derived Hematologic Neoplasms after Hematopoietic Stem Cell Transplantation: A Systematic Review. Biol Blood Marrow Transplant 2018; 24:1505-1513. [PMID: 29410295 DOI: 10.1016/j.bbmt.2018.01.033] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 01/25/2018] [Indexed: 02/07/2023]
Abstract
Development of de novo hematologic malignancies in donor cells after allogeneic stem cell transplantation (allo-SCT) provides a useful in vivo model to study the process of leukemogenesis. A systematic analysis of the cases reported in the literature was performed to identify risk factors and mechanisms involved in the pathogenesis of donor cell-derived hematologic neoplasms (DCHN) and leukemogenic transformation. Relevant data were extracted from 137 cases. Cases of DCHN show a wide heterogeneity with regard to recipient/donor age, sex mismatch, and conditioning regimen. Some characteristics, such as the type of primary disease, the type of hematologic malignancy of the DCHN, and the stem cell source used in the transplant procedure, differ from those expected. Mechanisms involved in the pathogenesis of DCHN are complex, and several hypotheses have been proposed, such as pre-existing hematologic neoplasms or premalignant clones in the donor, decreased immune surveillance, and damage to bone marrow microenvironment in the recipient. Most likely several if not all these mechanisms play a role in DCHN development. Novel approaches, such as next-generation sequencing to study consecutive samples after allo-SCT in these patients, appear to be promising to decipher the mechanisms of leukemogenesis.
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Affiliation(s)
- Julia Suárez-González
- Genomics Unit, Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain
| | - Carolina Martínez-Laperche
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain.
| | - Mi Kwon
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Pascual Balsalobre
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Diego Carbonell
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - María Chicano
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
| | | | - David Serrano
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Jorge Gayoso
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - José Luis Díez-Martín
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain; Department of Medicine, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Ismael Buño
- Genomics Unit, Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
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16
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Taniguchi R, Muramatsu H, Okuno Y, Suzuki K, Obu S, Nakatochi M, Shimamura T, Takahashi Y, Horikoshi Y, Watanabe K, Kojima S. Comprehensive genetic analysis of donor cell derived leukemia with KMT2A rearrangement. Pediatr Blood Cancer 2018; 65. [PMID: 28921816 DOI: 10.1002/pbc.26823] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 08/03/2017] [Accepted: 08/24/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Donor cell leukemia (DCL) occurs after allogeneic hematopoietic stem cell transplantation. Several mechanisms, including occult leukemic/preleukemic subclones in the donor graft and germline predisposition to leukemia, are proposed to be associated with DCL's molecular pathogenesis. We report a comprehensive genetic analysis of a patient with KMT2A-rearranged DCL after allogeneic bone marrow transplantation for refractory cytopenia of childhood. PROCEDURE We performed a whole-exome sequencing of the recipient's peripheral blood before transplant and the donor's peripheral blood and the recipient's bone marrow at the time of DCL diagnosis. RNA sequencing was also performed to detect fusion genes in DCL blasts. RESULTS There were no germline mutations that were associated with a predisposition to leukemia in the recipient and donor. Furthermore, there were no detectable somatic alterations except KMT2A-MLLT10 and other related gene fusions in DCL. KMT2A-MLLT10 was not detectable in the donor's bone marrow. CONCLUSION We propose a novel pattern of the molecular pathogenesis of DCL solely involving a genetic mutation acquired after transplant with no identifiable genetic factor related to the donor and recipient.
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Affiliation(s)
- Rieko Taniguchi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Hideki Muramatsu
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yusuke Okuno
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Kyogo Suzuki
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Satoshi Obu
- Department of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Masahiro Nakatochi
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Teppei Shimamura
- Division of Systems Biology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshiyuki Takahashi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuo Horikoshi
- Department of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Kenichiro Watanabe
- Department of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Seiji Kojima
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
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17
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Mature lymphoid malignancies: origin, stem cells, and chronicity. Blood Adv 2017; 1:2444-2455. [PMID: 29296894 DOI: 10.1182/bloodadvances.2017008854] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/10/2017] [Indexed: 12/15/2022] Open
Abstract
The chronic behavior of mature lymphoid malignancies, with relapses occurring years apart in many patients, has until recently been unexplained. Patterns of relapse also differ vastly between disease entities, with some being highly curable by chemotherapy whereas others are destined to reemerge after treatment. Lately, the use of next-generation sequencing techniques has revealed essential information on the clonal evolution of lymphoid malignancies. Also, experimental xenograft transplantation point to the possible existence of an ancestral (stem) cell. Such a malignant lymphoid stem cell population could potentially evade current therapies and be the cause of chronicity and death in lymphoma patients; however, the evidence is divergent across disease entities and between studies. In this review we present an overview of genetic studies, case reports, and experimental evidence of the source of mature lymphoid malignancy and discuss the perspectives.
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18
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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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19
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Kinsella FAM, Amel Kashipaz MR, Scarisbrick J, Malladi R. Donor-derived mycosis fungoides following reduced intensity haematopoietic stem cell transplantation from a matched unrelated donor. BMJ Case Rep 2017; 2017:bcr-2016-216331. [PMID: 28073814 PMCID: PMC5256493 DOI: 10.1136/bcr-2016-216331] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 46-year-old woman with a history of dasatinib-resistant chronic myeloid leukaemia, clonal evolution and monosomy 7 underwent reduced intensity conditioned in vivo T-cell-depleted allogeneic haematopoietic stem cell transplantation (HSCT) from a matched unrelated donor. Following the transplantation, she developed recurrent cutaneous graft versus host disease (GvHD), which required treatment with systemic immunosuppression and electrocorporeal photophoresis. Concurrently, she developed a lichenoid rash with granulomatous features suggestive of cutaneous sarcoidosis. Additional treatment with hydroxychloroquine was initially successful, but 2 months later, she developed erythroderma with palpable lymphadenopathy. Repeated histological analysis established a diagnosis of folliculotropic mycosis fungoides stage IVA2, and the malignant clone was confirmed to be of donor origin. A positive response to brentuximab has been shown. This is the first reported case of primary mycosis fungoides after matched unrelated donor HSCT, and in a patient still undergoing treatment for GvHD.
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Affiliation(s)
| | | | - Julia Scarisbrick
- Department of Dermatology, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Ram Malladi
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
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20
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Nicolay JP, Schneider S, Gaiser T, Felcht M, Klemke CD. Differential expression of cancer stem cell markers in cutaneous and systemic lymphoma. Exp Dermatol 2016; 25:561-3. [DOI: 10.1111/exd.12951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Jan P. Nicolay
- Department of Dermatology, Venereology and Allergy; University Medical Center Mannheim; Ruprecht-Karls-University of Heidelberg; Mannheim Germany
- Department of Immunogenetics; German Cancer Research Center; Heidelberg Germany
| | - Sven Schneider
- Institute for Clinical Chemistry; University Medical Center Mannheim; Ruprecht-Karls-University of Heidelberg; Mannheim Germany
| | - Timo Gaiser
- Institute for Pathology; University Medical Center Mannheim; Ruprecht-Karls-University of Heidelberg; Mannheim Germany
| | - Moritz Felcht
- Department of Dermatology, Venereology and Allergy; University Medical Center Mannheim; Ruprecht-Karls-University of Heidelberg; Mannheim Germany
| | - Claus-Detlev Klemke
- Department of Dermatology, Venereology and Allergy; University Medical Center Mannheim; Ruprecht-Karls-University of Heidelberg; Mannheim Germany
- Hautklinik, Städtisches Klinikum Karlsruhe; Karlsruhe Germany
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21
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Aikawa V, Porter D, Luskin MR, Bagg A, Morrissette JJD. Transmission of an expanding donor-derived del(20q) clone through allogeneic hematopoietic stem cell transplantation without the development of a hematologic neoplasm. Cancer Genet 2015; 208:625-9. [PMID: 26628205 DOI: 10.1016/j.cancergen.2015.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/23/2015] [Accepted: 10/23/2015] [Indexed: 10/22/2022]
Abstract
Donor cell leukemia is a rare complication of allogeneic hematopoietic stem cell transplantation (HSCT), which may result from the development of a new malignancy in previously healthy donor cells after transplant into the recipient, or it may derive from the transmission of an occult leukemia from donor to recipient. We report a case of donor derived 20q11.2 deletion in a male patient who received an allogeneic HSCT from his HLA-identical sister for the treatment of his chronic lymphocytic leukemia. Bone marrow cells from the donor were found to contain the 20q deletion that expanded over time, but which was absent in her peripheral blood cells. Although cases of donor cell leukemia after HSCT have been reported, in this case there has been no evidence of an associated hematologic neoplasm in either the donor or recipient. Pre-transplant donor bone marrow evaluations are not practical or warranted, however the finding of new cytogenetic abnormalities after transplant mandates a thorough evaluation of the donor.
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Affiliation(s)
- Vania Aikawa
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - David Porter
- Division of Hematology and Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Marlise R Luskin
- Division of Hematology and Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Adam Bagg
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jennifer J D Morrissette
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
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22
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Brown NA, Ross CW, Gudjonsson JE, Wale D, Pawarode A, Maillard I, Hristov AC. Subcutaneous panniculitis-like T-cell lymphoma with bone marrow involvement. Am J Clin Pathol 2015; 143:265-73. [PMID: 25596253 DOI: 10.1309/ajcpvzyb19nedxxz] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES To describe a rare case of subcutaneous panniculitis-like T-cell lymphoma (SPTCL) with morphologic and immunophenotypic evidence of bone marrow involvement. METHODS Biopsy specimens of skin and subcutis and bone marrow were examined using H&E-stained sections. Immunohistochemical studies for CD2, CD3, CD4, CD5, CD7, CD8, CD20, CD30, CD56, and granzyme B were reviewed. In addition, T-cell receptor γ gene rearrangement studies were performed. RESULTS A bone marrow core biopsy demonstrated several lymphohistiocytic aggregates containing atypical, cytotoxic T cells that rimmed adipocytes and were associated with karyorrhexis. These T cells were morphologically and immunophenotypically identical to a concurrent SPTCL, expressing CD2, CD3, CD7, CD8, and granzyme B but with diminished CD5 expression. CONCLUSIONS SPTCL may rarely involve the bone marrow. Bone marrow infiltrates show a similar morphologic and immunophenotypic appearance to those in the subcutaneous fibroadipose tissue, including rimming of adipocytes by neoplastic lymphocytes.
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Affiliation(s)
- Noah A. Brown
- Department of Pathology, University of Michigan, Ann Arbor
| | | | | | - Daniel Wale
- Department of Radiology, University of Michigan, Ann Arbor
| | | | - Ivan Maillard
- Department of Internal Medicine, University of Michigan, Ann Arbor
- Life Sciences Institute, University of Michigan, Ann Arbor
| | - Alexandra C. Hristov
- Department of Pathology, University of Michigan, Ann Arbor
- Department of Dermatology, University of Michigan, Ann Arbor
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23
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24
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Fahy CMR, Fortune A, Quinn F, McMenamin ME, Browne PV, Langabeer S, McCarron S, Hayden P, Marren P, Ni Chonghaile M, Irvine AD, Vandenberghe E, Barnes L. Development of mycosis fungoides after bone marrow transplantation for chronic myeloid leukaemia: transmission from an allogeneic donor. Br J Dermatol 2014; 170:462-7. [PMID: 24116988 DOI: 10.1111/bjd.12647] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2013] [Indexed: 01/07/2023]
Abstract
We report on a patient who developed donor-derived cutaneous T-cell lymphoma (CTCL) 4 years after successful treatment of chronic myeloid leukaemia with an allogeneic bone marrow transplant. The patient developed an eczematous rash unresponsive to topical therapy and immunosuppression. When CTCL was diagnosed in the recipient, his sibling donor had been attending his local dermatology unit with a maculosquamous rash, which proved subsequently to be mycosis fungoides. An identical pattern of donor and recipient clonality assessment and T-cell receptor gene sequencing indicated that the CTCL was probably transmitted in the bone marrow harvest. This suggests that CTCL cells circulate in the marrow at an early subclinical stage in this disease. This is the second case of donor-derived CTCL reported to date.
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Affiliation(s)
- C M R Fahy
- Department of Dermatology, St James' Hospital, Trinity College Dublin, Dublin, Ireland
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25
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Hamdi A, Afrough A, Muzzafar T, Popat UR, Hosing CM, Qazilbash MH, Lu G. Donor cell-derived myelodysplastic syndrome with ring chromosome 7 after allogeneic hematopoietic stem cell transplant in 2 patients with lymphomas as primary disease. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2014; 14:e151-5. [PMID: 25022600 DOI: 10.1016/j.clml.2014.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 04/30/2014] [Indexed: 01/09/2023]
MESH Headings
- Allografts
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Biomarkers, Tumor
- Bone Marrow/pathology
- Cell Transformation, Neoplastic/genetics
- Chromosome Deletion
- Chromosomes, Human, Pair 7/genetics
- Chromosomes, Human, Pair 7/ultrastructure
- Cyclophosphamide/administration & dosage
- Disease Progression
- Female
- Gene Deletion
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Myeloid, Acute/etiology
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Living Donors
- Lymphoma, Follicular/drug therapy
- Lymphoma, Follicular/therapy
- Lymphoma, Mantle-Cell/drug therapy
- Lymphoma, Mantle-Cell/therapy
- Male
- Middle Aged
- Myelodysplastic Syndromes/etiology
- Myelodysplastic Syndromes/genetics
- Myelodysplastic Syndromes/pathology
- Neoplasms, Second Primary/etiology
- Neoplasms, Second Primary/pathology
- Peripheral Blood Stem Cell Transplantation
- Proto-Oncogene Proteins c-ets/deficiency
- Proto-Oncogene Proteins c-ets/genetics
- Repressor Proteins/deficiency
- Repressor Proteins/genetics
- Ring Chromosomes
- Rituximab
- Transplantation Chimera/genetics
- Vidarabine/administration & dosage
- Vidarabine/analogs & derivatives
- ETS Translocation Variant 6 Protein
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Affiliation(s)
- Amir Hamdi
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Aimaz Afrough
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tariq Muzzafar
- Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Uday R Popat
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Chitra M Hosing
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Muzaffar H Qazilbash
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Gary Lu
- Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX.
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26
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Kreft A, Springer E, Geissinger E, Wagner EM, Bender K, Kolbe K, Hainz M, Rosenwald A, Herr W, Kirkpatrick CJ, Meyer RG. Transmission of angioimmunoblastic T-cell lymphoma by bone marrow transplant. Leuk Lymphoma 2014; 56:1164-7. [PMID: 25120051 DOI: 10.3109/10428194.2014.949702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Andreas Kreft
- Institute of Pathology, University Medical Center Mainz , Mainz , Germany
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27
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A Case of Mycosis Fungoides Transmitted From Donor to Recipient, and Review of Literature of T-Cell Malignancies After Transplantation. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2014; 14:e137-40. [DOI: 10.1016/j.clml.2014.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 01/30/2014] [Accepted: 02/11/2014] [Indexed: 11/19/2022]
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28
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Unrelated adult stem cell donor medical suitability: recommendations from the World Marrow Donor Association Clinical Working Group Committee. Bone Marrow Transplant 2014; 49:880-6. [DOI: 10.1038/bmt.2014.67] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 02/06/2014] [Accepted: 02/20/2014] [Indexed: 11/08/2022]
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29
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Janikova A, Mareckova A, Baumeisterova A, Krejci M, Supikova J, Salek D, Horky O, Tichy B, Hanke I, Pospisilova S, Moulis M, Mayer J. Transmission of t(11;14)-positive cells by allogeneic stem cell transplant: 10-year journey to mantle cell lymphoma. Leuk Lymphoma 2014; 55:1935-8. [DOI: 10.3109/10428194.2013.858150] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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30
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Tilson MP, Jones RJ, Sexauer A, Griffin CA, Morsberger LA, Batista DAS, Small D, Burns KH, Gocke CD, Vuica-Ross M, Borowitz MJ, Duffield AS. Targeted pathologic evaluation of bone marrow donors identifies previously undiagnosed marrow abnormalities. Biol Blood Marrow Transplant 2013; 19:1254-9. [PMID: 23769818 DOI: 10.1016/j.bbmt.2013.05.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 05/17/2013] [Indexed: 11/19/2022]
Abstract
Potential bone marrow donors are screened to ensure the safety of both the donor and recipient. At our institution, potential donors with abnormal peripheral blood cell counts, a personal history of malignancy, or age >60 years are evaluated to ensure that they are viable candidates for donation. Evaluation of the marrow includes morphologic, flow cytometric, and cytogenetic studies. A total of 122 potential donors were screened between the years of 2001 and 2011, encompassing approximately 10% of all donors. Of the screened potential donors, the mean age was 59 years and there were 59 men and 63 women. The donors were screened because of age >60 years (n = 33), anemia (n = 22), cytopenias other than anemia (n = 27), elevated peripheral blood counts without a concurrent cytopenia (n = 20), elevated peripheral blood counts with a concurrent cytopenia (n = 10), history of malignancy (n = 4), abnormal peripheral blood differential (n = 3), prior graft failure (n = 1), history of treatment with chemotherapy (n = 1), and body habitus (n = 1). Marrow abnormalities were detected in 9% (11 of 122) of donors. These donors were screened because of anemia (5 of 22, 23%), age >60 years (2 of 33, 6%), history of malignancy (2 of 4, 50%), elevated peripheral blood counts (1 of 20, 5%), and body habitus (1 of 1, 100%). Abnormalities included plasma cell dyscrasia (n = 3), abnormal marrow cellularity (n = 3), clonal cytogenetic abnormalities (n = 2), low-grade myelodysplastic syndrome (1), a mutated JAK2 V617F allele (n = 1), and monoclonal B cell lymphocytosis (n = 1). Our experience indicates that extended screening of potential donors identifies a significant number of donors with previously undiagnosed marrow abnormalities.
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Affiliation(s)
- Matthew P Tilson
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21231, USA
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31
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Camp BJ, Busam KJ, Brownell I, Koehne G, Hedvat C, Pulitzer MP. Donor-derived lymphomatoid papulosis in a stem-cell transplantation recipient. J Clin Oncol 2011; 29:e855-8. [PMID: 22042951 DOI: 10.1200/jco.2011.37.7101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Brendan J Camp
- Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA
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Wiseman DH. Donor cell leukemia: a review. Biol Blood Marrow Transplant 2010; 17:771-89. [PMID: 20951819 DOI: 10.1016/j.bbmt.2010.10.010] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Accepted: 10/08/2010] [Indexed: 10/18/2022]
Abstract
Relapse of acute leukemia following hematopoietic stem cell transplantation (HSCT) usually represents return of an original disease clone, having evaded eradication by pretransplant chemo-/radiotherapy, conditioning, or posttransplant graft-versus-leukemia (GVL) effect. Rarely, acute leukemia can develop de novo in engrafted cells of donor origin. Donor cell leukemia (DCL) was first recognized in 1971, but for many years, the paucity of reported cases suggested it to be a rare phenomenon. However, in recent years, an upsurge in reported cases (in parallel with advances in molecular chimerism monitoring) suggest that it may be significantly more common than previously appreciated; emerging evidence suggests that DCL might represent up to 5% of all posttransplant leukemia "relapses." Recognition of DCL is important for several reasons. Donor-derivation of the leukemic clone has implications when selecting appropriate therapy, because seeking to enhance an allogeneic GVL effect would intuitively not have the same role as in standard recipient-derived relapses. There are also broader implications for donor selection and workup, particularly given the growing popularity of nonmyeloblative HSCT and corresponding rising age of the potential donor pool. Identification of DCL raises potential concerns over future health of the donor, posing ethical dilemmas regarding responsibilities toward donor notification (particularly in the context of cord blood transplantation). The entity of DCL is also of research interest, because it might provide a unique human model for studying the mechanisms of leukemogenesis in vivo. This review presents and collates all reported cases of DCL, and discusses the various strategies, controversies, and pitfalls when investigating origin of posttransplant relapse. Putative etiologic factors and mechanisms are proposed, and attempts made to address the difficult ethical questions posed by discovery of donor-derived malignancy within a HSCT recipient.
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Affiliation(s)
- Daniel H Wiseman
- Haematology Department, Manchester Royal Infirmary, Manchester, United Kingdom.
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Christian B, Zhao W, Hamadani M, Sotomayor EM, Navarro W, Devine SM, Racke F, Blum KA. Mantle cell lymphoma 12 years after allogeneic bone marrow transplantation occurring simultaneously in recipient and donor. J Clin Oncol 2010; 28:e629-32. [PMID: 20733121 DOI: 10.1200/jco.2010.29.8992] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Beth Christian
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
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34
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Yang H, Lee J, Seed CR, Keller AJ. Can Blood Tranfusion Transmit Cancer? A Literature Review. Transfus Med Rev 2010; 24:235-43. [DOI: 10.1016/j.tmrv.2010.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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35
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Phelan PJ, Murphy RKJ, Farrell M, O'Toole O, Heffernan J, O'Brien D, Breathnach O, Conlon PJ. EBV-positive B cell cerebral lymphoma 12 years after sex-mismatched kidney transplantation: post-transplant lymphoproliferative disorder or donor-derived lymphoma? Nephrol Dial Transplant 2010; 25:2032-5. [PMID: 20348150 DOI: 10.1093/ndt/gfq170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We present a follow-up case report of possible transmission of lymphoma 12 years after deceased-donor renal transplantation from a male donor who was found at autopsy to have had an occult lymphoma. The female recipient underwent prompt transplant nephrectomy. However, 12 years later, she presented with cerebral B cell lymphoma. A donor origin for the cerebral lymphoma was supported by in situ hybridization demonstration of a Y chromosome in the lymphoma. There was a dramatic resolution of the cerebral lesions with tapering of immunosuppression and introduction of rituximab treatment. The finding of a Y chromosome in the cerebral lymphoma does not exclude a host contribution to lymphoma development.
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Affiliation(s)
- Paul J Phelan
- Department of Nephrology, Beaumont Hospital, Dublin, Ireland.
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36
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Risks and Mechanisms of Oncological Disease Following Stem Cell Transplantation. Stem Cell Rev Rep 2010; 6:411-24. [DOI: 10.1007/s12015-010-9134-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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37
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Santos-Briz A, Romo A, Antúnez P, Román C, Alcoceba M, Garcia JL, Vazquez L, González M, Unamuno P. Primary cutaneous T-cell lymphoproliferative disorder of donor origin after allogeneic haematopoietic stem-cell transplantation. Clin Exp Dermatol 2009; 34:e778-81. [PMID: 19817764 DOI: 10.1111/j.1365-2230.2009.03509.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A 56-year-old male patient had a history of mantle-cell lymphoma, which was treated with polychemotherapy and reduced-intensity conditioning allogeneic haematopoietic stem cell transplantation (ASCT) from his healthy sister with an identical human leucocyte antigen profile. Six years after transplantation, the patient developed asymptomatic eczema-like cutaneous lesions. Histologically the lesions contained a dense superficial lichenoid infiltrate, mainly consisting of CD4+ atypical medium to large lymphocytes showing indented hyperchromatic nuclei. In situ hybridization for Epstein-Barr virus was negative. PCR amplification of the T-cell receptor-gamma chain gene from several lesions revealed a monoclonal rearrangement without clonal variation. Two-colour fluorescence in situ hybridization (X and Y chromosomes) and microsatellite genotyping were used to compare samples from the patient (transplant recipient), his sister (donor) and the skin biopsy sample, which confirmed that the origin of the neoplastic cells was the donor graft. To our knowledge, this is the first case of post-transplant primary cutaneous T-cell lymphoproliferative disorder after ASCT.
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Affiliation(s)
- A Santos-Briz
- Department of Pathology, Hospital Universitario de Salamanca, Salamanca, Spain.
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38
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Glasser L, Meloni-Ehrig A, Greaves W, Demel KC, Butera J. Synchronous development of acute myeloid leukemia in recipient and donor after allogeneic bone marrow transplantation: report of a case with comments on donor evaluation. Transfusion 2009; 49:555-62. [DOI: 10.1111/j.1537-2995.2008.02008.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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39
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Occurrence of AML in cells of donor origin after treatment of CML in relapse with imatinib and donor stem cell boost 16 years after the original allogeneic BMT. Bone Marrow Transplant 2009; 44:265-6. [PMID: 19234516 DOI: 10.1038/bmt.2009.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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40
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Frey NV, Leid CE, Nowell PC, Tomczak E, Strauser HT, Kasner M, Goldstein S, Loren A, Stadtmauer E, Luger S, Hexner E, Hinkle J, Porter DL. Trisomy 8 in an allogeneic stem cell transplant recipient representative of a donor-derived constitutional abnormality. Am J Hematol 2008; 83:846-9. [PMID: 18819096 DOI: 10.1002/ajh.21268] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Trisomy 8 is a common cytogenetic abnormality in myeloid malignancies. It can also be present constitutionally and is associated with a wide range of phenotypes. We report a case of a 20-year-old woman with acute myelogenous leukemia associated with the 11q23/MLL translocation who underwent allogeneic hematopoietic stem cell transplantation (HSCT) from a healthy, unrelated 26-year-old female. Cytogenetics on a bone marrow biopsy and aspirate performed 71 days after transplant to evaluate pancytopenia identified trisomy 8 in 6 of 7 cells examined. The bone marrow was hypocellular but normal by morphology and flow cytometry. Fluorescent in situ hybridization (FISH) for the original 11q23/MLL translocation was negative. Chimerism analysis using multiplex polymerase chain reaction to amplify an informative short tandem repeat demonstrated 97% donor cells. These findings were confirmed by repeat bone marrow biopsies at Day 110 after transplant and 1 year after transplant. With resolution of comorbid illness, the patient's peripheral blood counts recovered and remained normal at 1 year after HSCT. FISH analysis of a cryopreserved sample of the donor graft showed trisomy 8 in 120 of 200 cells examined. This represents the first reported case of a person with constitutional trisomy 8 mosaicism serving as a stem cell donor. The case illustrates the importance of identifying donor-derived constitutional abnormalities to avoid the assumption that these cytogenetic abnormalities after HSCT are representative of malignant disease.
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Affiliation(s)
- Noelle V Frey
- Division of Hematology-Oncology and Abramson Cancer Center, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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41
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Gallardo F, Pujol RM. Subcutaneous Panniculitic-Like T-Cell Lymphoma and Other Primary Cutaneous Lymphomas with Prominent Subcutaneous Tissue Involvement. Dermatol Clin 2008; 26:529-40, viii. [DOI: 10.1016/j.det.2008.05.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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42
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Dickson BC, Chung CTS, Patterson BJ, Riddell RH, Kamel-Reid S, Messner HA, Lipton JH. Precursor lymphoblastic lymphoma reoccurring as a donor-derived neoplasm: a case report and review of the literature. Arch Pathol Lab Med 2008; 132:1342-5. [PMID: 18684038 DOI: 10.5858/2008-132-1342-pllraa] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2008] [Indexed: 11/06/2022]
Abstract
Precursor lymphoblastic lymphoma is an uncommon neoplasm. We report the case of a man who presented with precursor T lymphoblastic lymphoma and ultimately received an allogeneic bone marrow transplant from his human leukocyte antigen-identical sister. Four years later he developed recurrent disease. By means of DNA probing for the amelogenin locus and fluorescence in situ hybridization, the neoplastic cells of the recurrent lesion were found to be of donor origin. We offer the report of a patient with an unusual lymphoblastic lymphoma who, after successful bone marrow transplantation, developed the same disease of donor cell origin; further, we offer a literature review on donor cell lymphoma.
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Affiliation(s)
- Brendan C Dickson
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
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43
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High frequency of unrecognized indolent hematological disorders among HLA-matched siblings of patients with lymphoproliferative malignancies eligible for allo-SCT. Bone Marrow Transplant 2008; 42:427-8. [PMID: 18587433 DOI: 10.1038/bmt.2008.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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44
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Harbell JW, Dunn TB, Fauda M, John DG, Goldenberg AS, Teperman LW. Transmission of anaplastic large cell lymphoma via organ donation after cardiac death. Am J Transplant 2008; 8:238-44. [PMID: 18021286 DOI: 10.1111/j.1600-6143.2007.02033.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Recently, donation after cardiac death (DCD) has been encouraged in order to expand the donor pool. We present a case of anaplastic T-cell lymphoma transmitted to four recipients of solid organ transplants from a DCD donor suspected of having bacterial meningitis. On brain biopsy, the donor was found to have anaplastic central nervous system T-cell lymphoma, and the recipient of the donor's pancreas, liver and kidneys were found to have involvement of T-cell lymphoma. The transplanted kidneys and pancreas were excised from the respective recipients, and the kidney and pancreas recipients responded well to chemotherapy. The liver recipient underwent three cycles of chemotherapy, but later died due to complications of severe tumor burden. We recommend transplanting organs from donors with suspected bacterial meningitis only after identification of the infectious organism. In cases of lymphoma transmission, excision of the graft may be the only chance at long-term survival.
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Affiliation(s)
- J W Harbell
- Department of Surgery, New York University Medical Center, New York, NY, USA
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45
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Edgren G, Hjalgrim H, Reilly M, Tran TN, Rostgaard K, Shanwell A, Titlestad K, Adami J, Wikman A, Jersild C, Gridley G, Wideroff L, Nyrén O, Melbye M. Risk of cancer after blood transfusion from donors with subclinical cancer: a retrospective cohort study. Lancet 2007; 369:1724-30. [PMID: 17512857 DOI: 10.1016/s0140-6736(07)60779-x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Although mechanisms for detection of short-term complications after blood transfusions are well developed, complications with delayed onset, notably transmission of chronic diseases such as cancer, have been difficult to assess. Our aim was to investigate the possible risk of cancer transmission from blood donors to recipients through blood transfusion. METHODS We did a register-based retrospective cohort study of cancer incidence among patients who received blood from donors deemed to have a subclinical cancer at the time of donation. These precancerous donors were diagnosed with a cancer within 5 years of the donation. Data from all computerised blood bank registers in Sweden and Denmark gathered between 1968 and 2002 were merged into a common database. Demographic and medical data, including mortality and cancer incidence, were ascertained through linkages with nationwide, and essentially complete, population and health-care registers. The risk of cancer in exposed recipients relative to that in recipients who received blood from non-cancerous donors was estimated with multivariate Poisson regression, adjusting for potential confounding factors. FINDINGS Of the 354 094 transfusion recipients eligible for this analysis, 12,012 (3%) were exposed to blood products from precancerous donors. There was no excess risk of cancer overall (adjusted relative risk 1.00, 95% CI 0.94-1.07) or in crude anatomical subsites among recipients of blood from precancerous donors compared with recipients of blood from non-cancerous donors. INTERPRETATION Our data provide no evidence that blood transfusions from precancerous blood donors are associated with increased risk of cancer among recipients compared with transfusions from non-cancerous donors.
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Affiliation(s)
- Gustaf Edgren
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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46
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Gandhi MJ, Strong DM. Donor derived malignancy following transplantation: a review. Cell Tissue Bank 2007; 8:267-86. [PMID: 17440834 DOI: 10.1007/s10561-007-9036-1] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2007] [Accepted: 02/12/2007] [Indexed: 02/06/2023]
Abstract
Organ and tissue transplant is now the treatment of choice for many end stage diseases. In the recent years, there has been an increasing demand for organs but not a similar increase in the supply leading to a severe shortage of organs for transplant resulted in increasing wait times for recipients. This has resulted in expanded donor criteria to include older donors and donors with mild disease. In spite of implementation of more stringent criteria for donor selection, there continues to be some risk of donor derived malignancy. Malignancy after transplantation can occur in three different ways: (a) de-novo occurrence, (b) recurrence of malignancy, and (c) donor-related malignancy. Donor related malignancy can be either due to direct transmission of tumor or due to tumor arising in cells of donor origin. We will review donor related malignancies following solid organ transplantation and hematopoeitic progenitor cell transplantation. Further, we will briefly review the methods for detection and management of these donor related malignancies.
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Affiliation(s)
- Manish J Gandhi
- Department of Pathology and Immunology, Washington University, 660 S Euclid Ave #8118, St Louis, MO 63110, USA.
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Abstract
Recent experimental data offer convincing evidence for the existence of cancer stem cells in leukaemia, brain tumors and breast cancer. These cells are responsible for the maintenance of tumor growth and relapses after cytoreductive treatments. This paper provides a brief overview of current data supporting the idea of cancer stem cells in the pathogenesis of cutaneous malignancies, including skin carcinoma, malignant melanoma and cutaneous T-cell lymphoma. The characterization of putative cancer stem cells is important to develop new therapies selectively targeting these cells.
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Affiliation(s)
- Maria R Kamstrup
- Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark.
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48
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Hart J, Turner AR, Larratt L, Russell J, Franko B, Frantz C, Paonessa T, Mansoor A, Lai R. Transmission of a follicular lymphoma by allogeneic bone marrow transplantation ? evidence to support the existence of lymphoma progenitor cells. Br J Haematol 2007; 136:166-7. [PMID: 17096686 DOI: 10.1111/j.1365-2141.2006.06398.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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49
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Cetin Z, Tezcan G, Karauzum SB, Kupesiz A, Manguoglu AE, Yesilipek A, Luleci G, Hazar V. Donor cell-derived acute myeloblastic leukemia after allogeneic peripheral blood hematopoietic stem cell transplantation for juvenile myelomonocytic leukemia. J Pediatr Hematol Oncol 2006; 28:763-7. [PMID: 17114967 DOI: 10.1097/01.mph.0000243660.48808.72] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Despite its rarity, donor cell leukemia (DCL) is a most intriguing entity. We report here the case of a 5 year-old girl with juvenile myelomonocytic leukemia and normal female karyotype who developed acute myeloblastic leukemia with a karyotype of 46, X, t(X; 7) (p21; p11.2), der(7) t(3; 7) (q13.3; q22) 5 months after peripheral blood hematopoietic stem cell transplantation from her HLA-matched sister. We performed the analysis of short tandem repeat sequence markers to DNA obtained from donor peripheral blood, patient's peripheral blood including leukemic blasts and patient's hair root. This analysis showed that the leukemic blood DNA matched the donor blood DNA and not the patient's DNA, thus confirming DCL. To our knowledge, this is the first case of DCL after peripheral blood SCT for juvenile myelomonocytic leukemia.
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MESH Headings
- Blood Donors
- Child, Preschool
- Chromosome Aberrations
- Fatal Outcome
- Female
- Humans
- Leukemia, Myeloid, Acute/etiology
- Leukemia, Myelomonocytic, Chronic/complications
- Leukemia, Myelomonocytic, Chronic/genetics
- Leukemia, Myelomonocytic, Chronic/therapy
- Neoplasms, Second Primary
- Peripheral Blood Stem Cell Transplantation/adverse effects
- Transplantation Chimera/genetics
- Transplantation, Homologous
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Affiliation(s)
- Zafer Cetin
- Department of Pediatrics, Akdeniz University, Antalya, Turkey
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50
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Jabeen R, Payne D, Wiktorowicz J, Mohammad A, Petersen J. Capillary electrophoresis and the clinical laboratory. Electrophoresis 2006; 27:2413-38. [PMID: 16718719 DOI: 10.1002/elps.200500948] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Over the past 15 years, CE as an analytical tool has shown great promise in replacing many conventional clinical laboratory methods, such as electrophoresis and HPLC. CE's appeal was that it was fast, used very small amounts of sample and reagents, was extremely versatile, and was able to separate large and small analytes, whether neutral or charged. Because of this versatility, numerous methods have been developed for analytes that are of clinical interest. Other than molecular diagnostic and forensic laboratories CE has not been able to make a major impact in the United States. In contrast, in Europe and Japan an increasing number of clinical laboratories are using CE. Now that automated multicapillary instruments are commercially available along with cost-effective test kits, CE may yet be accepted as an instrument that will be routinely used in the clinical laboratories. This review will focus on areas where CE has the potential to have the greatest impact on the clinical laboratory. These include analyses of proteins found in serum and urine, hemoglobin (A1c and variants), carbohydrate-deficient transferrin, forensic and therapeutic drug screening, and molecular diagnostics.
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Affiliation(s)
- Rukhsana Jabeen
- University of Texas Medical Branch--Pathology, Galveston, TX 77555-0551, USA
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