Acute myeloid leukemia arising from a donor derived premalignant hematopoietic clone: A possible mechanism for the origin of leukemia in donor cells

• Donor leukemia following allogeneic bone marrow transplantation may not be as rare.
• Acute leukemia arises from a quiescent preexisting donor derived hematopoietic clone.
• Telomere erosion and replicative stress in normal donor cells results in senescence.
• Selective proliferation of clone with MLL amplification results in donor leukemia.
• The results provide mechanistic insight into leukemogenesis in donor derived cells.

During recent years, it has become increasingly evident that donor leukemia following allogeneic transplant may be more common then realized in the past. We identified five cases of potential donor leukemia cases during past five years. The precise mechanism of the origin of such leukemias, however, remains poorly defined. In this short communicati