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Blood, 19 February 2009, Vol. 113, No. 8, pp. 1834-1840.
Prepublished online as a Blood First Edition Paper on December 5, 2008; DOI 10.1182/blood-2008-07-171702.


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TRANSPLANTATION

Donor-derived oral squamous cell carcinoma after allogeneic bone marrow transplantation

Anne Janin13, Hideyuki Murata13, Christophe Leboeuf1,2, Jean-Michel Cayuela1,2,4, Eliane Gluckman2,5, Luc Legrès1,2, Allison Desveaux1,2, Mariana Varna1,2, Philippe Ratajczak1,2, Jean Soulier1,2,4, Hugues de Thé2,6,7, Philippe Bertheau13, and Gérard Socié1,2,5

1 Inserm, U728, Paris; 2 Université Paris VII, Institut Universitaire d'Hématologie (IUH), Paris; 3 Service de Pathologie, 4 Laboratoire Central d'Hématologie, 5 Service d'Hématologie Greffe, and 6 Service de Biochimie B, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis, Paris; and 7 Centre National de la Recherche Scientifique (CNRS), Unité Propre de Recherche (UPR) Unité Mixte de Recherche (UMR) 7151, Université Paris VII, Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), IUH, Paris, France

In animal models, tissue stem cells were proposed to exhibit an unexpected level of plasticity, although issues on cell fusions have lead to some controversies. Only transplantation experiments using genetically distinct recipients and donors can unequivocally show these changes in cell fate. We have analyzed oral squamous cell carcinomas arising in 8 long-term survivors of allogeneic bone marrow transplantation, in whom chronic graft-versus-host disease greatly favors development of squamous cell carcinomas, possibly as a consequence of lichenoid mucosal inflammation. With the use of 2 independent methods, (1) combined immunostaining and fluorescent in situ hybridization (FISH) analysis for X and Y chromosomes sequences in sex-mismatched grafts and (2) comparison of microsatellite typing of laser-microdissected tumor, donor, and recipient cells, in all tumors, we showed that 4 of these 8 epithelial tumors actually arose from the engrafted allogeneic bone marrow. Thus, donor-derived bone marrow cells, whether hematopoietic or mesenchymal, recruited to sites of chronic mucosal inflammation yielded epithelial tumors. Our observations therefore show that marrow cells in humans have a major role in epithelial cancer formation after allogeneic transplantation.


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