Donor cell-derived leukemia (DCL) is a rare complication of allogeneic hematopoietic cell transplantation (allo-HCT), previously described in patients receiving allo-HCT for hematologic malignancies. Allo-HCT has also been investigated as an immunotherapy platform for solid tumors including clear cell renal cell carcinoma (RCC).
Herein, we describe a unique patient case treated by allo-HCT for RCC who subsequently developed DCL. A 40-year-old man was diagnosed with metastatic clear cell RCC treated surgically by left nephrectomy plus metastasectomy of a rib lesion.
He was referred to the Fred Hutchinson Cancer Center and treated by allo-HCT as part of a clinical trial (NCT00005851). His initial allograft following fludarabine/2 Gy total body irradiation (TBI) conditioning was complicated by graft failure.
After collecting a G-CSF-mobilized autologous hematopoietic stem cell product as a failsafe for repeated graft failure, he was re-transplanted from the same donor following cyclophosphamide/antithymocyte globulin (ATG) conditioning, resulting in successful engraftment. Fourteen months later, he developed donor origin acute myelomonocytic leukemia with central nervous system (CNS) involvement.
Frontiers in Immunology published a clinical update in Infectious Disease on 26 May 2026.
The item focuses on Case Report: donor cell-derived leukemia after allogeneic stem cell transplantation for metastatic renal cell carcinoma.
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