Page 353 - Haematologica Vol. 109 - July 2024

CASE REPORT
mediated the recovery of a full complete chimerism, is high- ly probable and in accordance with the series reported by Taylor and colleagues1 where the only patient with long-term survival had received HSCT. In addition to the anti-tumor effect mediated by the allogenic reaction, we were able to identify a neoantigen-specific T-cell response restricted by an HLA allele shared between the donor and the patient (HLA-B*54), detectable at two time points. The long-term persistence of this neoantigen-specific T-cell response suggests a potential role in the favorable outcome of this patient with an extremely poor prognosis and provides an additional clinical observation supporting the importance of genomic instability, mutational load and neoantigens in both anti-tumor immunity and response to immunotherapy.10
Authors
Vassilis Genoud,1* Valérie Dutoit,2,3* Nhu-Nam Tran Thang,1*° Andrew Janowczyk,4° Thomas McKee,3,5 Yves Chalandon,1,3 Petros Tsantoulis1,3 and Pierre-Yves Dietrich1,2,3°
1Department of Oncology, Geneva University Hospital, Geneva; 2Laboratory of Tumor Immunology, Faculty of Medicine and Center for Translational Research in Onco-Hematology, University of Geneva, Geneva; 3Swiss Cancer Center Léman, Lausanne; 4SIB Swiss Institute of Bioinformatics, Lausanne and 5Clinical Pathology Service, Geneva University Hospital, Geneva, Switzerland
*VG, VD and N-NTT contributed equally as first authors.
°P-YD current address: Hirslanden Clinique des Grangettes, Chêne Bougeries, Switzerland
°N-NTT current address: Clinique de la Source, Lausanne, Switzerland °AJ current addresses: Department of Biomedical Engineering, Emory
References
1. Taylor J, Donoghue MT, Ho C, et al. Germ cell tumors and associated hematologic malignancies evolve from a common shared precursor. J Clin Invest. 2020;130(12):6668-6676.
2. Hiramatsu H, Morishima T, Nakanishi H, et al. Successful treatment of a patient with Klinefelter’s syndrome complicated by mediastinal germ cell tumor and AML(M7). Bone Marrow Transplant. 2008;41(10):907-908.
3. Spencer Chapman M, May PC, Olavarria E, Nadal Melsio E. Three distinct hematological malignancies from a single germ cell tumor: a case report. J Med Case Rep. 2020;14(1):222.
4. Magers MJ, Kao CS, Cole CD, et al. “Somatic-type” malignancies arising from testicular germ cell tumors: a clinicopathologic study of 124 cases with emphasis on glandular tumors supporting frequent yolk sac tumor origin. Am J Surg Pathol. 2014;38(10):1396-1409.
5. Orazi A, Neiman RS, Ulbright TM, Heerema NA, John K, Nichols CR. Hematopoietic precursor cells within the yolk sac tumor component are the source of secondary hematopoietic malignancies in patients with mediastinal germ cell tumors.
University, Atlanta, GA, USA; Department of Clinical Pathology, Geneva University Hospital, Geneva, Switzerland and Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
Correspondence:
P-Y. DIETRICH - pierre-yves.dietrich@hirslanden.ch
https://doi.org/10.3324/haematol.2023.284318
Received: September 20, 2023. Accepted: December 27, 2023. Early view: January 4, 2024.
©2024 Ferrata Storti Foundation Published under a CC BY-NC license
Disclosures
No conflicts of interest to disclose.
Contributions
VG, VD and NT conceived and wrote the article. AJ and PT analyzed and interpreted the patient molecular data. TMK performed the histological examination. YC and PYD managed the patient. PYD conceived the treatment protocol. All authors read and approved the final manuscript.
Acknowledgments
Written consent from the patient was obtained to publish this case report.
Data-sharing statement
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
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megakaryoblastic leukemia with isochromosome (12p) after a primary mediastinal germ cell tumor in Korea. J Korean Med Sci. 2011;26(8):1099-1102.
7. Akizuki K, Sekine M, Kogure Y, et al. TP53 and PTEN mutations were shared in concurrent germ cell tumor and acute megakaryoblastic leukemia. BMC Cancer. 2020;20(1):5.
8. Lu C, Riedell P, Miller CA, et al. A common founding clone with TP53 and PTEN mutations gives rise to a concurrent germ cell tumor and acute megakaryoblastic leukemia. Cold Spring Harb Mol Case Stud. 2016;2(1):a000687.
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