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.
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.