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Tissue-based chimerism analysis enhances detection of donor-derived neoplasia in allogeneic stem cell transplant patients

Bone Marrow Transplantation volume 52, pages 634–637 (2017)Cite this article

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A number of cases of allogeneic hematopoietic stem cell transplant (allo-HCT) patients presenting with donor-derived neoplasms (DDN) has been reported.1, 2 Even if the morphological findings were identical, host-derived therapy-related myeloid neoplasms (t-MN) and DDN are distinct diseases, with potentially different treatments.3 However, the current World Health Organization classification does not distinguish them, which is misleading, as the transplanted cells of DDN were never exposed to mutagenic agents used for the patient’s original disease.

On the basis of the distinct pathophysiology driving DDN versus therapy-related myeloid neoplasms, distinguishing them is clinically relevant. If a post allo-HCT neoplasm is determined to be host-derived, reduction of immunosuppression and donor lymphocyte infusion would be considered.4 This approach would not be favored if the new malignancy was donor-derived, in which case a search for another allogeneic stem cell donor could be warranted.

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Authors and Affiliations

  1. Department of Pathology, Yale University School of Medicine, New Haven, CT, USA

    E G Baraban, P Hui & M L Xu

  2. Division of Pathology/Laboratory Medicine, Department of Hematopathology, University of Texas MD Anderson Cancer Center, Austin, TX, USA

    S Hu

  3. Department of Internal Medicine, Division of Hematology, Yale Cancer Center, Smilow Cancer Hospital at the Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA

    N Podoltsev

  4. Blood and Marrow Transplant Program, Robert Wood Johnson University, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA

    D Cooper

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  1. E G Baraban
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  2. S Hu
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  6. M L Xu
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Correspondence to M L Xu.

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Supplementary Information accompanies this paper on Bone Marrow Transplantation website

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Baraban, E., Hu, S., Hui, P. et al. Tissue-based chimerism analysis enhances detection of donor-derived neoplasia in allogeneic stem cell transplant patients. Bone Marrow Transplant 52, 634–637 (2017). https://doi.org/10.1038/bmt.2016.332

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