We report the transmission of acute myeloid leukemia (AML) undetected at donation from a deceased organ donor to two kidneys and one liver recipients. We reviewed the medical records, and performed molecular analyses and whole exome sequencing (WES) to ascertain AML donor origin and its molecular evolution. The liver recipient was diagnosed 11 months after transplantation and died from complications 2 months later. The two kidney recipients (R1 and R2) were diagnosed 19 and 20 months after transplantation and both received treatment for leukemia. R1 died of complications 11 months after diagnosis, while R2 went into complete remission for 44 months, before relapsing. R2 died 10 months later of complications from allogenic bone marrow transplantation. Microsatellite analysis demonstrated donor chimerism in circulating cells from both kidney recipients. Targeted molecular analyses and medical records revealed NPM1 mutation present in the donor and recipients, while FLT3 was mutated only in R1. These findings were confirmed by WES, which revealed additional founder and clonal mutations, and HLA genomic loss in R2. In conclusion, we report the first in‐depth genomic analysis of AML transmission following solid organ transplantation, revealing distinct clonal evolution, and providing a potential molecular explanation for tumor escape.

Luigi Marchionni

Francisco Pereira Lobo

Rumen Kostadinov

Anna Serra

Federico Genzano Besso

Silvia Deaglio

Piero Stratta

Monica Berrino

Claudio Zanettini

Eddie Luidy Imada

Mohamed N. Omar

Gianluca Gaidano

Benedetto Bruno

Giuseppe Saglio

Antonio Amoroso

American Journal of Transplantation

范围是国际移植学科。这包括器官和组织的捐赠和保存；组织损伤、修复、炎症和老化；免疫识别、调节、效应机制和诱导耐受的机会；组织相容性；与移植相关的药物和药理学；移植物存活和预防移植物功能障碍和失败；临床试验和人群分析；移植并发症；异种移植；以及伦理和社会问题。科学包括细胞生物学、医学、外科、儿科和传染病的相关方面。该杂志包括胸腔移植（心脏、肺）、腹部移植（肾、肝、胰腺、胰岛）、组织移植和相关主题。

The American Journal of Transplantation is a journal that covers the field of international transplantation. This includes organ and tissue donation and preservation; tissue injury, repair, inflammation, and aging; immune recognition, regulation, mechanisms of action, and opportunities for inducing tolerance; tissue compatibility; drugs and pharmacology related to transplantation; graft survival and prevention of graft dysfunction and failure; clinical trials and population analyses; transplant complications; xenotransplantation; as well as ethical and social issues. The scientific scope includes relevant aspects of cell biology, medicine, surgery, pediatrics, and infectious diseases. The journal covers thoracic transplantation (heart, lung), abdominal transplantation (kidney, liver, pancreas, islet), tissue transplantation, and related topics.

《American Journal of Transplantation》是一个涵盖国际移植学科的期刊，内容包括器官和组织的捐赠与保存、组织损伤与修复、炎症与老化、免疫识别与调节机制、组织相容性、与移植相关的药物与药理学、移植物存活及预防移植物功能障碍和失败的研究、临床试验与人群分析、移植并发症、异种移植以及伦理与社会问题。该期刊涉及细胞生物学、医学、外科、儿科和传染病等相关领域，涵盖胸腔移植（心脏、肺）、腹部移植（肾、肝、胰腺、胰岛）、组织移植及相关主题。

Donor-derived acute myeloid leukemia in solid organ transplantation

The first in‐depth genomic analysis of AML transmission following solid organ transplantation is reported, revealing distinct clonal evolution, and providing a potential molecular explanation for tumor escape.

Category	Quartile
医学	2
医学, 移植	1
医学, 外科	2

Donor-derived acute myeloid leukemia in solid organ transplantation

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