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
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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.