Therapy‐related myelodysplastic syndrome of recipient origin after allogeneic bone marrow transplantation for acute lymphoblastic leukaemia
Therapy‐related myelodysplastic syndrome of recipient origin after allogeneic bone marrow transplantation for acute lymphoblastic leukaemia
复制标题
急性淋巴细胞白血病同种异体骨髓移植后治疗相关的受者源性骨髓增生异常综合征
DOI：
10.1046/j.1365-2141.2001.02518.x
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发表时间：
2001
影响因子：
6.5
通讯作者：
Y. Kwong
中科院分区：
文献类型：
--
作者：
W. Au;A. Lie;S. Ma;Y. Leung;L. Siu;Y. Kwong
治疗相关骨髓增生异常综合征（t-MDS）是异基因骨髓移植（BMT）的一种非常罕见的并发症。一名患有T急性淋巴细胞白血病（T-ALL）的女性接受了来自具有β地中海贫血特征的供体的同种异体BMT。骨髓移植后五年，红细胞指数恢复正常后，最初转换为小红细胞，这意味着自体造血再生。BMT后7年，出现血小板减少症，骨髓检查证实为t-MDS，特征性核型为46，XX，inv（3）（q21;q26），del（5）（q13），add（17）（p11）。供体/受体嵌合体的回顾性分子分析显示，BMT后受体细胞逐渐再生，在t-MDS时达到顶峰。我们的研究结果说明了异基因BMT后t-MDS的异常发生。受体造血的重新出现可能预示着与进行BMT的原始肿瘤克隆不同的血液恶性肿瘤的发展。
Therapy‐related myelodysplastic syndrome (t‐MDS) is a very rare complication of allogeneic bone marrow transplantation (BMT). A woman with T acute lymphoblastic leukaemia (T‐ALL) received an allogeneic BMT from a donor with the β‐thalassaemic trait. Five years after BMT, the red cell indices returned to normal after an initial conversion to microcytosis, implying autologous haematopoietic regeneration. Seven years after BMT, thrombocytopenia developed and marrow examination confirmed t‐MDS, with a characteristic karyotype 46,XX,inv(3)(q21;q26), del(5)(q13),add(17)(p11). Retrospective molecular analysis of donor/recipient chimaerism showed gradual regeneration of recipient cells after BMT, culminating at the time of t‐MDS. Our findings illustrate the unusual occurrence of t‐MDS after allogeneic BMT. Re‐emergence of recipient haematopoesis may herald the development of a haematological malignancy different from the original neoplastic clone for which the BMT was performed.