Abstract
Monosomy 7 arises as a recurrent chromosome aberration in donor cell leukemia after hematopoietic stem cell transplantation. We report a new case of donor cell leukemia with monosomy 7 following HLA-identical allogenic bone marrow transplantation for severe aplastic anemia (SAA). The male patient received a bone marrow graft from his sister, and monosomy 7 was detected only in the XX donor cells, 34 months after transplantation. The patient’s bone marrow microenvironment may have played a role in the leukemic transformation of the donor hematopoietic cells.
Highlights
Allogeneic bone marrow transplantation (BMT) is a successful therapy for patients with severe aplastic anemia (SAA)
Donor cell leukemia (DCL) or donor cell myelodysplastic syndrome are complications that have been observed after hematopoetic transplantation with progenitor cells harvested from bone marrow and peripheral blood, and after cord blood transplantation (Browne et al, 1991)
Hypotheses offered to explain the development of DCL include transfer of oncogenic material from host to donor cells, immunosuppression after BMT leading to inadequate immune surveillance, leukemic transformation of engrafted cells, and occult leukemia in the donor cells (Neglia et al, 1991)
Summary
Allogeneic bone marrow transplantation (BMT) is a successful therapy for patients with severe aplastic anemia (SAA). A rare complication after BMT for SAA is the development of acute leukemia (Klingemann et al, 1986). Most of the DCL cases occurred in patients transplanted for acute leukemias.
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