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Case Reports in Nephrology
Volume 2015 (2015), Article ID 821346, 5 pages
http://dx.doi.org/10.1155/2015/821346
Case Report

Donor-Derived Myeloid Sarcoma in Two Kidney Transplant Recipients from a Single Donor

1Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA
2Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA
3Department of Internal Medicine, Section on Hematology and Oncology, Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC 27103, USA
4Department of General Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA
5Department of Pharmacy, Wake Forest School of Medicine, Winston-Salem, NC 27103, USA

Received 19 January 2015; Accepted 6 April 2015

Academic Editor: Gianna Mastroianni Kirsztajn

Copyright © 2015 Amudha Palanisamy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We report the rare occurrence of donor-derived myeloid sarcoma in two kidney transplant patients who received organs from a single deceased donor. There was no evidence of preexisting hematologic malignancy in the donor at the time of organ recovery. Both recipients developed leukemic involvement that appeared to be limited to the transplanted organ. Fluorescence in situ hybridization (FISH) and molecular genotyping analyses confirmed that the malignant cells were of donor origin in each patient. Allograft nephrectomy and immediate withdrawal of immunosuppression were performed in both cases; systemic chemotherapy was subsequently administered to one patient. Both recipients were in remission at least one year following the diagnosis of donor-derived myeloid sarcoma. These cases suggest that restoration of the immune system after withdrawal of immunosuppressive therapy and allograft nephrectomy may be sufficient to control HLA-mismatched donor-derived myeloid sarcoma without systemic involvement.