Donor stem cell‐derived paroxysmal nocturnal hemoglobinuria after umbilical cord blood transplantation
Donor stem cell‐derived paroxysmal nocturnal hemoglobinuria after umbilical cord blood transplantation
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脐带血移植后供体干细胞源性阵发性睡眠性血红蛋白尿
DOI：
10.1111/ejh.13498
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发表时间：
2020
影响因子：
3.1
通讯作者：
Yamane Takahisa
中科院分区：
文献类型：
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作者：
Nakaya Yosuke;Nakao Takafumi;Ueda Yasutaka;Takamori Hiroyuki;Nishimura Jun‐Ichi;Tatsumi Naoko;Tsutsumi Minako;Yoshida Masahiro;Yoshimura Takuro;Hayashi Yoshiki;Yamane Takahisa
供体细胞源性血液病（DCHD）是异基因造血干细胞移植（HSCT）的一种罕见并发症。在过去十年中，DCHD的报告数量一直在增加，这可能反映了hsct数量的增加和识别供体细胞来源的能力的提高。阵发性夜间血红蛋白尿（PNH）是一种获得性血液学疾病，在造血干细胞克隆扩增的背景下引起的，该造血干细胞含有磷脂酰肌醇糖锚定生物合成的体细胞突变，a类。我们在这里报告了一例成人T细胞白血病/淋巴瘤患者，在脐带血移植后7年发生PNH。患者在HSCT后通过全供体嵌合保持完全缓解。因此，PNH来源于供体干细胞。脐带血移植后受体不成熟的免疫环境可能是导致新生儿脐带血干细胞克隆扩增迅速，在短时间内发生典型症状性PNH的原因。据我们所知，这是文献中首次报道移植后供体干细胞发生PNH的病例。
Donor cell‐derived hematological disorder (DCHD) is a rare complication of allogeneic hematopoietic stem cell transplantation (HSCT). The number of reports of DCHD has been increasing in the last decade, which likely reflects the growing number of HSCTs and the improved ability to identify the donor cell origin. Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired hematological disorder arising in the context of clonal expansion of hematopoietic stem cells harboring a somatic mutation in phosphatidylinositol glycan anchor biosynthesis, class A. We report here a patient with adult T‐cell leukemia/lymphoma, who developed PNH 7 years after umbilical cord blood transplantation. The patient has maintained complete remission with full‐donor chimerism after HSCT. Thus, PNH was derived from stem cells of donor origin. The immature immune environment in the recipient after cord blood transplantation might have contributed to the rapid clonal expansion for neonatal stem cells in cord blood to develop typical symptomatic PNH in a short period. To the best of our knowledge, this is the first report in the literature of a case of PNH that developed in donor stem cells after HSCT.