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Successful use of second cord blood transplantation to achieve long-term remission in cord blood donor cell-derived AML harboring a FLT3-ITD and an NPM1 mutation

Bone Marrow Transplantation volume 47, pages 1252–1253 (2012)Cite this article

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Donor cell leukemia (DCL) is a rare but serious complication following allo-SCT. Although the etiology of DCL is not well understood, DCL oncogenesis is probably a multifactorial process involving the convergent interplay of different influences. Proposed mechanisms include preleukemic potential in donor cells, replicative stress, impaired immune surveillance and defective marrow microenvironment. Although case numbers remain small, there has not been a consistent chromosome abnormality identified to date, with a normal karyotype being demonstrated in approximately one third of the reported cases.1 The use of chemotherapy for treatment of DCL can induce remissions but the treatment-related mortality is high because of a prior transplant. The optimal treatment strategy for DCL patients is unclear. Some researchers recently reported cases of DCL following cord blood transplantation (CBT), whereas its clinical features and pathogenesis remain to be fully elucidated.2, 3, 4, 5, 6, 7 Here, we report a successful case of second CBT in a patient with cord blood donor cell-derived AML harboring a FLT3 internal tandem duplication (FLT3-ITD) and an NPM1 mutation.

Previously, we reported the case of a female enteropathy-type T-cell lymphoma (ETCL) patient; the immunophenotype was CD3+, CD7+, CD8+, CD56+ and partially positive for granzyme B. She received CBT from a two-Ag-mismatched unrelated female donor in PR after chemotherapy. STR analysis performed on day +29 showed complete donor-type engraftment. She developed local relapse of ETCL on day +44, but achieved sustained CR after stopping tacrolimus.8

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Authors and Affiliations

  1. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan

    K Chonabayashi, T Kondo, K Yamamoto, Y Tanaka, Y Nagai, M Hishizawa & A Takaori-Kondo

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  1. K Chonabayashi
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  2. T Kondo
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  3. K Yamamoto
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Correspondence to T Kondo.

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Chonabayashi, K., Kondo, T., Yamamoto, K. et al. Successful use of second cord blood transplantation to achieve long-term remission in cord blood donor cell-derived AML harboring a FLT3-ITD and an NPM1 mutation. Bone Marrow Transplant 47, 1252–1253 (2012). https://doi.org/10.1038/bmt.2011.256

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