In a typical case, a woman aged 41 suffering from advanced stage chronic myeloid leukemia underwent bone marrow transplant and leukocyte infusion provided by her sister. This procedure treated leukemia, but both the sisters went on to develop follicular lymphoma after a span of 7 years. Though, the incidence of a malignancy being transferred by a donor is not something unheard, this research by scientists from the Dana Farber Cancer Institute helped the team get an insight into the genetic factors that cause follicular lymphoma.
“We were able to combine clinical activity with laboratory expertise to gain a real insight into the biology involved,” commented David Weinstock, M.D., an assistant professor of medicine at Dana-Farber Cancer Institute.
In the analysis, the DNA patterns of both the sisters were sequenced and a frozen specimen of the leukocyte infusion was also scrutinized. This provided the scientists an understanding of the genetic lesions that caused lymphoma.
As per the observations, both the sisters seemed to have matching BCL2/IGH and V(D)J rearrangements. Moreover, about 15 mutations were seen in the 2 lymphomas. By accessing ultra-deep sequencing, the team stumbled upon 14 of these mutations attained from the donor lymphocyte infusions.
Thus, the aforesaid finding implied that a lymphoma ancestor possessing these mutations was apparently transited from the donor to the receiver 7 years prior to clinical results.
Presently, the 2 sisters are on chemotherapy undergoing remission. The team believed that the only therapeutic avenue currently available is stem cell transplantation. However, further trials are needed to gauge the genetic aberrations which lead to follicular lymphoma.
The research is published in the journal, Cancer Discovery.