Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access
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Case Report

Volume 14, Number 2, April 2025, pages 79-85

Donor Cell-Derived Chronic Lymphocytic Leukemia Presenting After Allogenic Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia

Figure

↓  Figure 1. Case 2 - flow cytometry analysis of the donor (a-e) and the recipient (f-j). CD19 cells were gated on the SSC/CD19 dot plot (a, f). In blood of the donor, cells show weaker expression of CD20 (b; y-axis), but stronger expression of CD23 (b; x-axis), compared to the recipient cells (g). (c) and (h) display expression of CD43 (x-axis) versus CD20 (y-axis). CD43 expression is slightly weaker in the donor than in the recipient. (d) and (i) show a significant difference in expression of FMC-7, which is stronger in the donor (d) in comparison with the recipient (i). The expression of CD5 is present in the donor (e), contrary to the lack of CD5 expression in the recipient’s blood (j).
Figure 1.

Table

↓  Table 1. Review of the Literature (Reported Cases of Donor-Derived CLL)
 
Case number Reference Primary diagnosis Patient’s age at DCL diagnosis Donor Source of stem cells Donor origin confirmation Age of donor at the moment of donation Time from allo-HSCT to diagnosis of DCL GVHD Malignant clone in donor Disease in donor Time from donation to donor malignancy
aDetection of clonal B-cell population with CLL phenotype, no proof of CLL criteria met at that time. ALL: acute lymphocytic leukemia; AML: acute myeloblastic leukemia; BM: bone marrow; CLL: chronic lymphocytic leukemia; CML: chronic myelocytic leukemia; DCL: donor cell leukemia; FISH: fluorescence in situ hybridization; GVHD: graft-vs-host disease; HSCT: hematopoietic stem cell transplantation; HLA: human leukocyte antigen; HSC: hematopoietic stem cells; IgH: immunoglobulin heavy chain; IgK: immunoglobulin kappa light chain; MDS: myelodysplastic syndrome; ND: no data; NHL: non-Hodgkin lymphoma; PB: peripheral blood; PCR: polymerase chain reaction; Sib: sibling donor; STR: short tandem repeats; VNTR: variable number of tandem repeats.
1 [5] MDS 62 Sib PB VNTR 70 28 days Yes Yes No -
2 [5] CML 16 Unrelated BM IgH VDJ rearrangement detection by PCR 45 12 years/10 years to clone Yes Yes Yes 2 years
3 [5] NHL 52 Unrelated PB VNTR 51 28 days Yes ND ND ND
4 [6] CLL 51 Sib (twin) BM IgH analysis 45 6 years No Yes Yes ND
5 [7] AML 65a Sib ND FISH 62 3 monthsa No Yes Yes 26 months
6 [8] CML 64 Sib PB STR, IgH analysis 67 8 years Yes Yes No -
7 [9] CLL 54a Sib PB FISH 58 5.58 yearsa Yes Yes Yes 5 years
8 [10] ALL 12a; 15 Unrelated ND IgH and IgK analysis, FISH 44 4 yearsa; 7.5 years Yes Yes Yes 1 year
9 [1] ALL 36 Unrelated BM VNTR or STR ND 9.98 years No ND ND ND
10 [1] AML 59 Sib PB VNTR or STR/FISH ND 10.02 years No Yes Yes 9.07 years
11 [1] CLL 50 Sib PB HLA typing ND 0.28 years No Yes Yes 1.42 years
12 Current case 1 AML 65 Sib PB STR 64 9.16 years Yes Yes Yes 9.51 years
13 Current case 2 AML 62 Sib PB STR 50 3.17years Yes Yes Yes 3.33 years