A Case of Donor Cell Leukemia after Allogenic Peripheral Blood Stem Cell Transplantation for Acute Promyelocytic Leukemia with PML-RARA

ABSTRACT

Donor cell leukemia (DCL), a rare but fatal complication arising from allogenic stem cell transplantation, is a complex disease associated with multiple pathophysiological processes. Specific diagnosis of DCL distinct from relapsed leukemia is important owing to its implications in setting up therapeutic approaches. Fluorescence in situ hybridization (FISH), short tandem repeat (STR), variable number tandem repeat (VNTR) tests, or informative single nucleotide polymorphism (SNP) analysis can be used to confirm the origin of leukemic cells from donor cells. Here, we report a case of DCL in a female patient after allogeneic peripheral stem cell transplantation from a male donor for the treatment of acute promyelocytic leukemia (APL) with PML-RARA. DCL developed 6 years after stem cell transplantation and leukemic cells of donor origin were confirmed by the presence of Y chromosome on the X/Y FISH analysis of bone marrow aspirate specimen. This is the first case of DCL reported in an APL patient in Korea.