| Title: |
Efficacy and Long-Term Remission Following Haploidentical HSCT for Therapy-Related Acute Myelomonocytic Leukemia with Plasmacytoid Dendritic Cells Post-FCR Therapy for CLL: A Case Report |
| Authors: |
Alina Camelia Catana; Lidia-Maria Mondoc; Maria-Gabriela Vladoiu; Zsofia Varady; Camelia Dobrea; Horia Mihail Sandu; Liliana Mocanu; Ariela Olteanu; Geanina Mera; Minodora Teodoru |
| Source: |
Journal of Clinical Medicine ; Volume 15 ; Issue 4 ; Pages: 1559 |
| Publisher Information: |
Multidisciplinary Digital Publishing Institute |
| Publication Year: |
2026 |
| Collection: |
MDPI Open Access Publishing |
| Subject Terms: |
CLL; FCR; haplotransplant; pDC-AMLs |
| Description: |
Introduction: Chronic lymphocytic leukemia (CLL) is a common adult leukemia often treated with fludarabine, cyclophosphamide, and rituximab (FCR). While effective, FCR can lead to therapy-related myeloid neoplasms (t-MN), including aggressive therapy-related acute myeloid leukemia (t-AML). Stem cell transplantation offers the best chance for long-term remission in these cases. Here, we report a rare case of t-AML with plasmacytoid dendritic cells (pDC-AML) developing after FCR treatment for CLL that was successfully treated with haplotransplantation. Case Presentation: A 57-year-old woman with CLL-B was treated with six cycles of FCR, achieving a complete response. Six years later, at age 63, she developed t-AML with a rare morphophenotypic subtype: acute myelomonocytic leukemia with plasmacytoid dendritic cells (pDC-AML) and monosomy 8. Diagnostic challenges included distinguishing this subtype from blastic plasmacytoid dendritic cell neoplasm (BPDCN). She was treated with high-dose cytarabine followed by haploidentical stem cell transplantation from her son. Haploidentical transplantation was prioritized due to the urgent clinical need in a patient with high-risk acute leukemia (therapy-related leukemia secondary to prior chemoimmunotherapy and failure to achieve complete remission following the standard 3 + 7 induction protocol). In this critical setting, the patient’s son was immediately available as an HLA-haploidentical donor. Prior to the performance of the haploidentical stem cell transplant from her son, no HLA-matched unrelated donor (MUD) could be identified. Another viable alternative would have been the utilization of umbilical cord blood-derived stem cells harvested from the patient’s twin granddaughters. She was closely monitored post-transplant for potential complications, including graft-versus-host disease (GVHD), post-transplant lymphoproliferative disorder, and thyroid dysfunction, all of which were ruled out during follow-up. The patient remains in complete remission 15 years after her ... |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
Hematology; https://dx.doi.org/10.3390/jcm15041559 |
| DOI: |
10.3390/jcm15041559 |
| Availability: |
https://doi.org/10.3390/jcm15041559 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.AFEABA12 |
| Database: |
BASE |