Donor-Cell Origin High-Risk Myelodysplastic Syndrome Synchronous with an Intracranial Meningioma-Like Tumor, 8 Years after Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Lymphocytic Leukemia

• Published in: Case reports in medicine 2017-01, Vol.2017 (2017), p.1-5
• Main Authors: Brás, G., Campos Júnior, António, Pinho Vaz, Carlos
• Format: Article
• Language: English
• Subjects: Biology; Bone marrow; Brain cancer; Cancer; Cancer therapies; Care and treatment; Case Report; Case reports; Chemotherapy; Chronic lymphocytic leukemia; Cytomegalovirus; Diagnosis; Disease; Drug therapy; Engraftment; Hematology; Hematopoietic stem cells; Hemorrhage; Leukemia; Lymphatic leukemia; Lymphocytes; Meningioma; Myelodysplastic syndrome; Myelodysplastic syndromes; Nervous system; NMR; Nuclear magnetic resonance; Patients; Radiation therapy; Remission; Risk factors; Stem cell transplantation; Stem cells; Transplantation; Transplants & implants
• ISSN: 1687-9627; 1687-9635
• DOI: 10.1155/2017/9674385

Secondary neoplasias are well known consequences of radiotherapy or chemotherapy for a primary cancer. In this report, we describe two rare secondary neoplasias occurring in the same patient: a meningioma-like intracranial tumor and high-risk myelodysplastic syndrome (MDS) of donor-cells origin, both diagnosed simultaneously, 8 years after an allogeneic hematopoietic stem cell transplantation (allo-HSCT) for chronic lymphocytic leukemia (CLL). Due to an engraftment failure during the first allo-HSCT of a matched related donor for CLL treatment, the salvage treatment was a second allo-HSCT. At the moment of meningioma-like tumor diagnosis, the patient was pancytopenic due to high-risk MDS, so it was decided to postpone a surgical intervention until hematological improvement. For the high-risk MDS of donor-cells origin the chosen treatment was induction with intensive chemotherapy. Due to refractory disease, the patient was treated with 5-azacitidine and donor-lymphocytes infusion with no response and, finally, a third allo-HSCT of a matched unrelated donor was performed. The patient died 6 months after the third allo-HSCT, in cytogenetic remission but without hematological recovery, due to an intracranial hemorrhage with origin in the meningioma-like tumor.