Donor Cell Leukemia: the Role of Recipient Microenvironment

Acute myeloid leukemia (AML) is one of the extreme outcomes of age-related clonal hematopoiesis (ARCH). In recent years, data on differences between pre-AML and ARCH have emerged. However, it is still enigmatic why ARCH is prevalent in the general aging population, whereas only very few individuals eventually develop AML. Whether ARCH is solely related to abnormal hematopoiesis or originates from impaired microenvironment (ME) needs to be elucidated. The current study aimed to explore dynamics of molecular changes occurring in rare patients developing late post-transplant donor cell leukemia (DCL) and the relation of these aberrations to ARCH and/or ME.