Abstract
A 50-year-old male developed acute lymphoblastic leukemia 100 months after allogeneic peripheral blood stem cell transplantation from his HLA-identical sister. A cytogenetic analysis of bone marrow cells revealed a normal karyotype of 46, XX. Therefore, this recipient was diagnosed with donor cell-derived acute lymphoblastic leukemia (DC-ALL). He did not achieve complete remission following chemotherapy, and subsequently underwent unrelated cord blood transplantation (CBT) using myeloablative conditioning. Thirty-four days after CBT, he achieved complete remission for DC-ALL and complete second donor-type engraftment. However, hemodialysis was initiated due to progressive renal failure. He died due to acute circulatory failure 362 days after CBT while maintaining complete remission for DC-ALL. In conclusion, CBT for DC-ALL may represent a promising therapeutic option. However, the further development of supportive care is particularly important in donor cell-derived leukemia patients because fatal complications following second transplantation may develop in these patients.
