급성전골수성백혈병 치료를 위한 동종말초혈액조혈모세포 이식 후에 발생한 공여세포백혈병 1예
A Case of Donor Cell Leukemia after Allogenic Peripheral Blood Stem Cell Transplantation for Acute Promyelocytic Leukemia with PML-RARA
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
공여세포백혈병은 드물지만 동종조혈모세포 이식의 치명적인 합병증으로 다양한 기전이 복합적으로 작용하여 발생하는 것으로 알려져 있다. 재발한 백혈병과 공여세포백혈병의 감별진단은 치료 전략을 세우는데 영향을 주기 때문에 매우 중요하다. 백혈병세포 의 공여세포 기원을 확인하기 위해 형광동소보합법(fluorescence in situ hybridization, FISH), 단편직렬반복(short tandem repeats, STR), 직렬반복변수(variable number of tandem repeats, VNTR), 단일염기다형성(informative SNP) 분석 등의 검사가 이용된다. 급 성전골수세포백혈병 치료를 위해 남성공유자의 말초조혈모세포 이식 후 여성환자에서 발생한 공여세포백혈병은 국내에서 보고된 바가 없기에 문헌고찰과 함께 이 증례를 보고하는 바이다. 환자는 조혈모세포를 이식하고 6년 후에 공여세포백혈병이 발병하였으며 백혈병세포의 공여세포 기원은 골수흡인조직의 백혈병세포에서 Y 염색체에 대한 FISH 검사로 확인하였다.
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
참고문헌 (15)
- Hertenstein B, "Development of leukemia in donor cells after allogeneic stem cell transplantation-a survey of the European Group for Blood and Marrow Transplantation (EBMT)", Haematologica, 90, pp.969~975 (2005)
- Wang E, "Donor cell-derived leukemias", myelodysplastic neoplasms in allogeneic hematopoietic stem cell transplant recipients : A clinicopathologic study of 10 cases and a comprehensive review of the literature, 2011, pp.135, 525~540
- 김은정, "중증 재생불량성 빈혈에 대한 동종골수이식 후에 발생한기증세포백혈병 1예", 대한내과학회지, 86(4), pp.510~514 (2014), 대한내과학회[DOI]
- Rashidi A, "FISH-negative, cytogenetically cryptic acute promyelocytic leukemia", Blood Cancer J, 5, pp.e320~ (2015)
- Wiseman DH, "Donor cell leukemia : A review", Biol Blood Marrow Transplant, 17, pp.771~789 (2011)
- Ruiz-Delgado GJ, "Donor cell leukemia(DCL) : A prospective study of its identification and treatment", Gac Med Mex, 151, pp.582~587 (2015)
- Niederwieser DW, "Inadvertent transmission of a donor’s acute myeloid leukemia in bone marrow transplantation for chronic myelocytic leukemia", N Engl J Med, 322, pp.1794~1796 (1990)
- Yasuda T, "Leukemic evolution of donor-derived cells harboring IDH2 and DNMT3A mutations after allogeneic stem cell transplantation", Leukemia, 28, pp.426~428 (2014)
- Kobayashi S, "Donor cell leukemia arising from preleukemic clones with a novel germline DDX41 mutation after allogenic hematopoietic stem cell transplantation", Leukemia, 31, pp.1020~1022 (2017)
- Comoli P, "Preemptive therapy of EBV-related lymphoproliferative disease after pediatric haploidentical stem cell transplantation", Am J Transplant, 7, pp.1648~1655 (2007)
- Wright EG, "Ionizing radiation and leukaemia : more questions than answers", Hematol Oncol, 23, pp.119~126 (2005)
- Cooley LD, "Donor cell leukemia : report of a case occurring 11 years after allogeneic bone marrow transplantation and review of the literature", Am J Hematol, 63, pp.46~53 (2000)
- Flynn CM, "Donor cell leukemia : insight into cancer stem cells and the stem cell niche", Blood, 109, pp.2688~2692 (2007)
- Curtis RE, "Solid cancers after bone marrow transplantation", N Engl J Med, 336, pp.897~904 (1997)
- Wynn RF, "Accelerated telomere shortening in young recipients of allogeneic bone-marrow transplants", Lancet, 351, pp.178~181 (1998)