Donor Cell-Derived Chronic Lymphocytic Leukemia Presenting After Allogenic Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia
Bibliographic record
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative approach for many hematologic disorders, and donor cell leukemia (DCL) remains a complication rarely observed after HSCT. The number of reported cases of DCL slightly exceeds 100, with acute myeloid leukemia (AML) being the most common type. To date, only a few cases of chronic lymphocytic leukemia (CLL) emerging from donor cells have been described in the literature. Here, we report two cases of CLL of donor origin, which emerged in patients after HSCT for AML. In the reported cases, patients maintained complete remission of AML after HSCT. Both donors were free of CLL before transplantation. Several years after HSCT (9 and 3 years, respectively), lymphocytosis with proven B-cell clonality was detected in recipients prompting a detailed blood analysis to be performed also in donors. CLL population was demonstrated in both cases. The first donor-recipient pair did not meet criteria for CLL treatment and eventually died from causes not related to underlying hematologic malignancy. The second couple received Bruton's tyrosine kinase inhibitors with good disease control. The presented cases raise the question of possible clonal evolution of B-lymphocytes in donor-origin cells. Prospective screening of potential donors for pre-malignant alterations remains a matter of discussion.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".