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Inadvertent transmission of occult CML through allo-SCT

Bone Marrow Transplantation volume 50, page 598 (2015)Cite this article

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Recurrence of original disease and secondary malignancy are both important causes of unsuccessful SCT. In both cases the malignant clone is host derived. On the other hand, donor cell leukemia is driven by the graft. This is very infrequent and only partially understood.1 A third and different scenario is the inadvertent transmission of occult leukemia from the donor. These cases are even more rare and raise major ethical considerations concerning the patient, the donor, the doctors and the BM registry systems.2, 3, 4

We have recently observed an atypical clinical case of inadvertent transmission of occult CML with allo-SCT. A 48-year-old male with no relevant medical past history was diagnosed with smoldering myeloma in 2004. First signs of progression were noted in September 2008 and at this time cytogenetic analysis revealed complex karyotype with: del13q14, three copies of 17 chromosomes, relative deletion of TP53 gene and a translocation involving 14q32. The first-line treatment was thalidomide plus dexamethasone, and after achieving a very good PR the patient was referred to high-dose melphalan conditioning regimen and auto-SCT. He maintained a very good PR for 2 years. At this point signs of aggressive progression led to second-line chemotherapy with bortezomib plus dexamethasone. The patient achieved a very good PR. Considering that this was a young patient with poor cytogenetic prognosis who had an HLA-matched sister, it was decided to proceed with the treatment with allogeneic peripheral SCT from the related donor.

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References

  1. Wiseman DH . Donor cell leukemia: a review. Biol Blood Marrow Transplant 2011; 17: 771–779.

    Article  Google Scholar 

  2. Niederwieser DW, Applbaum FR, Gastl G, Gersdorf E, Meister B, Geissler D et al. Inadvertent transmission of a donor's acute myeloid leukemia in bone marrow transplantation from chronic myelocytic leukemia. N Engl J Med 1990; 322: 1794–1796.

    Article  CAS  Google Scholar 

  3. Berg KD, Brinster NK, Huhn KM, Goggins MG, Jones RJ, Makary A et al. Transmission of a T-cell lymphoma by allogeneic bone marrow transplantation. N Engl J Med 2001; 345: 1458–1463.

    Article  CAS  Google Scholar 

  4. Baron F, Dresse MF, Beguin Y . Transmission of chronic myeloid leukemia through peripheral blood stem cell transplantation. N Engl J Med 2003; 349: 913–914.

    Article  Google Scholar 

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Authors and Affiliations

  1. Bone Marrow Transplantation Service, Portuguese Institute of Oncology, Porto, Portugal

    M D de Brito, F Campilho, R Branca, C P Vaz & A Campos

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  1. M D de Brito
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  2. F Campilho
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  3. R Branca
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  4. C P Vaz
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  5. A Campos
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Correspondence to M D de Brito.

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The authors declare no conflict of interest.

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de Brito, M., Campilho, F., Branca, R. et al. Inadvertent transmission of occult CML through allo-SCT. Bone Marrow Transplant 50, 598 (2015). https://doi.org/10.1038/bmt.2014.294

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