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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 Transplantation volume 44, pages 265–266 (2009)Cite this article

The occurrence of donor-derived AML is a rare event after allogeneic BMT, which on occasion can develop as a de novo secondary hematologic malignancy within a general susceptibility of secondary cancer after BMT. Furthermore, transmission of hematologic disturbances of donor origin has to be taken into consideration.

It is well known that hematological disorders can be transferred by hematopoietic stem cells1, 2 and even a few cases of secondary hematological diseases in stem cell recipients have been described.3, 4 On the other hand, development of AML has been observed during or after imatinib treatment for chronic phase CML5 and other chromosomal aberrations, such as trisomy 8 or monosomy 7, are commonly reported to be involved.6 Although the underlying mechanisms of donor-derived leukemogenesis are speculative and certainly multifactorial, the clonal conversion of intact hematopoietic progenitor cells in the absence of T-cell regulation, within an altered BM microenvironment, might be facilitated by signal transduction inhibition. As there is some evidence that imatinib inhibits CD8+ and also regulatory T cells,7 which are involved in tumor control, this might explain an increased mutagenic potential of BCR-ABL tyrosine kinase inhibitors under specific conditions.

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Authors and Affiliations

  1. Department of Bone Marrow Transplantation, University Hospital of Essen, Essen, Germany

    M Ditschkowski, C Schulte, R Trenschel & D W Beelen

  2. MLL Munich Leukemia Laboratory, Munich, Germany

    C Haferlach

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  1. M Ditschkowski
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  2. C Haferlach
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  3. C Schulte
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  4. R Trenschel
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  5. D W Beelen
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Correspondence to M Ditschkowski.

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Ditschkowski, M., Haferlach, C., Schulte, C. et al. 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 44, 265–266 (2009). https://doi.org/10.1038/bmt.2009.8

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