Posttransplant lymphoproliferative disorder complicating hematopoietic stem cell transplantation in a patient with dyskeratosis congenita

Olga L. Bohn, Joseph Whitten, Barbara Spitzer, Rachel Kobos, Susan Prockop, Farid Boulad, Maria Arcila, Lu Wang, Julie Teruya-Feldstein

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Dyskeratosis congenita (DC) is a rare inherited disorder characterized by bone marrow failure and cancer predisposition. We present a case of a 28-year-old woman with DC who was admitted for hematopoietic stem cell transplantation (HSCT) for aplastic anemia and who developed acute myeloid leukemia with complex genetic karyotype abnormalities including the MLL (11q23) gene, 1q25, and chromosome 8. After transplantation, a monomorphic Epstein-Barr virus (EBV) negative posttransplant-associated lymphoproliferative disorder (PTLD) diffuse large B-cell lymphoma was discovered involving the liver, omental tissue, and peritoneal fluid samples showing additional MLL (11q23) gene abnormalities by fluorescence in situ hybridization. Despite treatment, the patient died of complications associated with transplantation and invasive fungal infection. This case represents the first bona fide documented case of EBV-negative monomorphic PTLD host derived, with MLL gene abnormalities in a patient with DC, and shows another possible mechanism for the development of a therapy-related lymphoid neoplasm after transplantation.

Original languageEnglish
Pages (from-to)520-525
Number of pages6
JournalInternational Journal of Surgical Pathology
Volume21
Issue number5
DOIs
StatePublished - Oct 2013
Externally publishedYes

Keywords

  • acute myeloid leukemia
  • aplastic anemia
  • dyskeratosis congenita
  • posttransplant lymphoproliferative disorder

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