Development of mycosis fungoides after bone marrow transplantation for chronic myeloid leukaemia: transmission from an allogeneic donor. (18th February 2014)

• Record Type: Journal Article
• Authors: Fahy, C.M.R.; Fortune, A.; Quinn, F.; McMenamin, M.E.; Browne, P.V.; Langabeer, S.; McCarron, S.; Hayden, P.; Marren, P.; Ni Chonghaile, M.; Irvine, A.D.; Vandenberghe, E.; Barnes, L.
• Is Part Of: British journal of dermatology. Volume 170:Number 2(2014:Feb.)
• Page Start: 462
• Page End: 467
• Publication Date: 2014-02-18
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.12647
• Languages: English
• ISSNs: 0007-0963

Abstract

Abstract : What's already known about this topic? Patients are at an increased risk of malignancies following stem‐cell transplantation (SCT). These include both secondary malignancies associated with immunosuppression, and those transmitted by the SCT, from donor to recipient. What does this study add? This case highlights that in cutaneous T‐cell lymphoma (CTCL), cells that may be precursors to skin‐homing T cells are in the blood and bone marrow at an early disease stage. It is important to consider the relevance to the recipient of any disease in the donor, even years after the SCT. Multiple biopsies with T‐cell receptor gene rearrangement studies may be necessary to establish a diagnosis of CTCL in cases of refractory dermatitis. Summary: We report on a patient who developed donor‐derived cutaneous T‐cell lymphoma (CTCL) 4 years after successful treatment of chronic myeloid leukaemia with an allogeneic bone marrow transplant. The patient developed an eczematous rash unresponsive to topical therapy and immunosuppression. When CTCL was diagnosed in the recipient, his sibling donor had been attending his local dermatology unit with a maculosquamous rash, which proved subsequently to be mycosis fungoides. An identical pattern of donor and recipient clonality assessment and T‐cell receptor gene sequencing indicated that the CTCL was probably transmitted in the bone marrow harvest. This suggests that CTCL cells circulate in the marrow at an early subclinical stage in this disease. This is the second case of donor‐derived CTCL reported to date.