Status:
Ready to upload
Record number:
2043
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment for leukemia, lymphoma and plasmacytoma (Council of Europe, 2022):
Leukaemia, lymphoma and plasmacytoma diagnosed during donor procurement: These cancers are classified as an unacceptable risk for organ donation. Leukaemia, lymphoma and plasmacytoma in the donor history: Active (acute or chronic) leukaemia, lymphoma and plasmacytoma are an unacceptable risk for organ donation. Treated acute leukaemia and lymphoma after a definite disease-free interval of 10 years may be considered for organ donation with an assumed high risk for transmission.
Time to detection:
2 years
Alerting signals, symptoms, evidence of occurrence:
Gross hematuria, deteriorating renal function, jaundice and multiple subcutaneous nodules. PET CT scan showed multiple FDG avid masses. biopsy of kidney and subcutaneous nodule showed granulocytic sarcoma. FISH panel on auxiliary biopsy showed t(15;17).
Demonstration of imputability or root cause:
DNA short tandem repeat analysis showed donor origin.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Suggest new keywords:
Malignancy
Case report
Kidney transplant
FISH
DNA typing
Leukemia, myeloid, promyelocytic
Myelocytic sarcoma
Reference attachment:
Suggest references:
Alhuraiji A, Chebbo W, El-Gohary G, Chaudhri N, Almohareb F, Ibrahim K, et al. Donor-derived extramedullary acute promyelocytic leukemia post kidney transplant. Annals of hematology. 2015;94(3):505-7.
Note:
Carl-Ludwig: agree to Michael, suggest to add that it is worhtwhile to consider exclusion/confirmation of donor origin for further decision to plan therapy.
Expert comments for publication:
Patient was treated with specific chemotherapy and went into remission. The patient did not wish to have allograft nephrectomy. Graft was preserved and remained functional. The authors state that this represents the first case of extramedullary kidney donor transmitted acute promyelocytic leukemia, but also see Williams T et al, Leuk Lymph 2012;53(12):2530-4 for a similar case. The present case arose after 2 years, and the case of Williams et al. (Notify record #2045) arose after 6 years, indicating that long-term followup of these patients is necessary if the donor is found to have this disease (of note, if donor origin should be excluded in late occurence of such malignancies for further planning of therapeutic decisions)