{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:05:40Z","timestamp":1747188340514,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T00:00:00Z","timestamp":1675987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Late complications of chemotherapy include treatment\u2010related secondary leukemias. We describe an unusual case of a new treatment\u2010related acute lymphoblastic leukemia (t\u2010ALL) that was unmasked and mobilized by G\u2010CSF during autologous hematopoietic progenitor cell collection (HPCC) in a young man with testicular cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Electronic chart review of the patient medical history and pertinent laboratory findings. Patient CD34 and blast results were compared to 4249 autologous and 437 allogeneic HPCC performed between 2004 and 2022. In autologous donors, the %blast and %CD34 were compared by linear regression and paired t\u2010test using commercial software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patient was a 21\u2010year\u2010old male with relapsed testicular cancer referred for G\u2010CSF cytokine\u2010only mobilization and autologous HPCC. His pre\u2010mobilization WBC count and differential were normal. On the day of HPCC, his WBC\u00a0=\u00a037.9\u00a0K\/mcL with 12% blasts and 9.75% circulating CD34+ cells. The patient was admitted 9\u2009days after HPCC with a normal WBC count and 15% blasts. He was diagnosed with a pro\u2010B t\u2010ALL bearing an t(4:11)(q21:q23) translocation and <jats:italic>KMT2A\u2010AF4<\/jats:italic> rearrangement. Upon review, this patient had the highest %CD34 among 4686 HPCC and was the only donor with %CD34\u2009&gt;\u20091% after a cytokine\u2010only mobilization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We report a case of t\u2010ALL that mimicked CD34+ HPC and was mobilized by high\u2010dose G\u2010CSF. Up to 70% of secondary leukemias bear 11q23\/<jats:italic>KMT2A<\/jats:italic> rearrangements, which occur at the multipotent stem cell stage and can result in myeloid and lymphoid leukemias. Donors who have received past chemotherapy, especially with topoisomerase II inhibitors, are at increased risk for 11q23\/<jats:italic>KMT2A<\/jats:italic> leukemias.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.17269","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T10:37:25Z","timestamp":1676025445000},"page":"684-689","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A secondary <scp>CD34<\/scp>+ acute lymphoblastic leukemia unmasked and mobilized by <scp>G\u2010CSF<\/scp> in an autologous stem cell donor with testicular cancer"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0216-1599","authenticated-orcid":false,"given":"Laura","family":"Cooling","sequence":"first","affiliation":[{"name":"Department of Pathology University of Michigan Hospitals  Ann Arbor Michigan 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