Long-term persistence of nonpathogenic clonal chromosome abnormalities in donor hematopoietic cells after allogeneic stem cell transplantation.

Abstract

We describe the cases of two unrelated patients who exhibited multiple chromosomal abnormalities in donor cells after allogeneic peripheral blood stem cell transplantation (PBSCT). The patients were diagnosed with chronic myeloid leukemia and chronic lymphocytic leukemia, respectively, and both underwent nonmyeloablative conditioning with cyclophosphamide and fludarabine followed by PBSCT from their HLA-matched opposite-sex siblings. Post-transplant bone marrow cytogenetics showed full engraftment, and the early post-transplant studies demonstrated only normal donor metaphases. Subsequent studies of both patients, however, revealed a population of metaphase cells with abnormal, but apparently balanced, donor karyotypes. Chromosome studies performed on peripheral blood cells collected from both donors after transplantation were normal. Both patients remained in clinical remission during follow-up of approximately 8 years in one case, and 6 years in the other case, despite the persistence of the abnormal clones. Chromosomal abnormalities in residual recipient cells after bone marrow or PBSCT are not unusual. In contrast, only rare reports of chromosome abnormalities in donor cells exist, all of which have been associated with post-bone marrow transplant myelodysplastic syndrome or acute leukemias. The present cases demonstrate the rare phenomenon of persistent clonal nonpathogenic chromosome aberrations in cells of donor origin.

• Authors: Gulsun Erdag, Jeanne M Meck, Aurelia Meloni-Ehrig, Ludmila Matyakhina, Theresa Donohue, Ramaprasad Srinivasan, Philip Mowrey, JoAnn Kelly, Aleah Smith, Richard Childs
• Journal: Cancer genetics and cytogenetics (Cancer Genet Cytogenet) Vol. 190 Issue 2 Pg. 125-30 (Apr 15 2009) ISSN: 1873-4456 [Electronic] United States
• PMID: 19380032 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Chromosome Aberrations
• Female
• Hematopoietic Stem Cell Transplantation
• Humans
• Leukemia, Myelogenous, Chronic, BCR-ABL Positive (genetics, immunology)
• Male
• Middle Aged