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Donor cell origin of multiple myeloma occurring after allogeneic haematopoietic stem cell transplantation in a patient with refractory anaemia with ring sideroblast
  1. Young-Il Kim1,
  2. Hye-Ran Kim3,
  3. Myung-Geun Shin2,
  4. Young-Jin Lee4,
  5. Jong-Hee Shin2,
  6. Soon-Pal Suh2,
  7. Dong-Wook Ryang2
  1. 1Internal Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea
  2. 2Laboratory Medicine and Internal Medicine, Chonnam National University, Medical School and Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea
  3. 3Brain Korea 21 Project, Center for Biomedical Human Resources, Chonnam National University, Gwangju, Republic of Korea
  4. 4Department of Laboratory Medicine, Wonkwang University Hospital, Iksan, Republic of Korea
  1. Correspondence to Professor Myung-Geun Shin, Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, 160, Ilsimri, Hwasun-eup, Hwasun-gun, Jeollanam-do 519-890, Republic of Korea; mgshin{at}chonnam.ac.kr

Abstract

Post-transplant lymphoproliferative disorder (PTLD) is a rare but life-threatening complication after solid organ and haematopoietic stem cell transplantation. A 40-year-old woman who was diagnosed as having refractory anaemia with ring sideroblast 6 years ago took an ABO mismatched, unrelated allogeneic haematopoietic stem cell transplantation (HSCT) from a 32-year-old healthy male donor. The bone marrow (BM) study was carried out because of progressing pancytopenia, serum biclonal gammopathy and a distorted ratio of serum level of free κ and λ light chain 138 days after HSCT. The BM examination showed an increased number of plasma cells (12% of total marrow cells) comprising mainly CD45−CD19−CD138+ malignant plasma cells with an immunoglobulin heavy-chain gene rearrangement. Conventional cytogenetics and molecular personal identification studies revealed that all BM cells were totally replaced by donor cells, thus indicating the donor cell origin of PTLD-multiple myeloma. The BM microenvironment of the recipient might be associated with the development of PTLD-multiple myeloma.

  • Post-transplant lymphoproliferative disorder
  • multiple myeloma
  • donor origin
  • haematology
  • myeloma
  • transplantation

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Footnotes

  • Y-IK and H-RK contributed equally.

  • Funding This work (No R01-2008-000-10620-0) was supported by Mid-career Researcher Program through NRF grant funded by the MEST, Korea.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Institutional Review Board at Chonnam National University Hwasun Hospital, Hwasun, Korea.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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