{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T05:20:48Z","timestamp":1787721648382,"version":"build-2784847793"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Secondary myelodysplastic syndrome (sMDS) is increasing as more individuals survive treatment for a primary cancer diagnosis, which is associated with many factors, such as prior alkylator therapy, topoisomerase II inhibitors and higher-dose pretransplant irradiation, hematopoietic cell transplantation (HCT) and graft purging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We report a unique case of sMDS diagnosed 34 months after a sequential treatment regimen consisting of chemotherapy, autologous hematopoietic stem cell transplantation (auto-HSCT), and chimeric antigen receptor T (CAR-T) cell therapy for primary splenic diffuse large B-cell lymphoma (DLBCL). With reference to existing literature, we discuss plausible etiologic interpretations and research limitations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The patient was diagnosed with therapy-related myelodysplastic syndrome (t-MDS) with multihit-TP53. The patient achieved complete remission after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and achieved sustained complete remission with full donor chimerism during 18 months of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The case we reported highlights the cumulative risk of t-MDS associated with multi-modal intensive treatments for relapsed\/refractory DLBCL, even with initial disease control. The etiology of sMDS is multifactorial. This case may provide novel hypothesis-generating clues for exploring the mechanisms underlying clonal evolution under multimodal hematopoietic stress. This single case raises the hypothesis that early allo-HSCT may contribute to favorable prognosis, which needs validation in larger cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1882599","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T04:50:12Z","timestamp":1787719812000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diffuse large B\u2011cell lymphoma followed by myelodysplastic syndrome with TP53 mutation: a case report and literature review"],"prefix":"10.3389","volume":"16","author":[{"given":"Xue","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Hematology, the Affiliated Hospital of Chengde Medical College","place":["Chengde, Hebei, China"]},{"name":"Hebei Key Laboratory of Panvascular Diseases","place":["Chengde, 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