Increased incidence of acute myeloid leukemia after liver transplantation? Description of three new cases and review of the literature

Transplantation. 2004 Jan 27;77(2):311-3. doi: 10.1097/01.TP.0000102549.40531.13.

Abstract

Background: Acute myeloid leukemia (AML) after solid organ transplantation is rare, with only six AML cases after liver transplantation (LT) being reported.

Methods: Characteristics of three AML cases observed among 799 recipients of LT in the authors' institution and estimation of the standardized incidence ratio (SIR) are presented.

Results: Three AML cases were diagnosed (French-American-British classification subtypes M0, M3, and M1) at 38 days, 2 years, and 3.5 years after LT, respectively. The immunosuppressive regimen consisted of cyclosporine A and prednisone. The recipient's origin of blasts could be demonstrated in two cases. All patients achieved complete remission after standard treatment. Nonetheless, disease relapsed in two patients at 2 and 6 months, whereas the patient with acute promyelocytic leukemia remains disease-free 4 years after diagnosis. As compared with the general population, the observed incidence of AML in the authors' series of LT results in a significantly higher SIR of 11.41 (P=0.0023).

Conclusions: The higher SIR found in the authors' series suggests an increased risk of AML in patients undergoing LT.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Leukemia, Myeloid, Acute / epidemiology*
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Time Factors