Study: Two Sisters Suffer From Lymphoma

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Bone marrow transplant has been one of the new medical treatment options for patients with leukemia. It is the process by which health bone marrow cells replace the damaged bone marrow. Who would have thought that this life-saving intervention can lead to a possible problem? This was evident on the case of a 41-year old woman, with chronic-phase chronic myeloid leukemia, who received a bone marrow transplant and subsequent white blood cell infusion from her sister to relieve leukemia. After seven years, follicular lymphoma developed in both of them.  Presently, the siblings experience remission.

There had already been documented instances of similar cases, wherein donors pass on a malignancy; however, these have been considered of low risk to the members of the transplant community. More so, the scientists believe that this case paves the way to determine genetic abnormalities which can result to follicular lymphoma in both donor and recipient.

Dr. David Weinstock, assistant professor of medicine at the Dana-Farber Cancer Institute, stated that in order to obtain true understanding of the biology involves, they need to merge clinical activity with laboratory expertise. The case study initiated by Dr. Weinstock can be found in the recent issue of Cancer Discovery, the updated journal of the American Association for Cancer Research. This was funded by a Stand Up To Cancer Innovative Research Grant. On December 12, 2011, he and his colleagues made a presentation of their findings at the 2011 American Society of Hematology Annual Meeting and Exposition in San Diego.

Moreover, Dr. Weinstock and his team made a sequence from the DNA samples derived from the siblings. To ascertain the genetic lesion that resulted to the lymphoma, they further sequenced the leukocyte infusion frozen sample. The presence of identical BCL2/IGH and V (D) J rearrangements was noted from their findings. In addition, 15 mutations were found on both women’s lymphomas.

Furthermore, the team was able to obtain 14 of these mutations from the donor lymphocyte infusions, with the use of ultra-deep sequencing. This can mean that the lymphoma precursor, who already had the mutations, was passed to the recipient by the donor seven years prior to its clinical activation.

Weinstock believed that this breakthrough can lead to the path of discovering early treatment for follicular lymphoma, because the only therapeutic means that exist presently is stem cell transplantation. He further added that medical management can be well improved if we can have sufficient understanding on the genetic aberrations which cause follicular lymphoma.

 

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