{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:13:15Z","timestamp":1792181595595,"version":"4.4.0"},"reference-count":56,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Chronic lymphocytic leukemia (CLL) is a common adult leukemia often treated with fludarabine, cyclophosphamide, and rituximab (FCR). While effective, FCR can lead to therapy-related myeloid neoplasms (t-MN), including aggressive therapy-related acute myeloid leukemia (t-AML). Stem cell transplantation offers the best chance for long-term remission in these cases. Here, we report a rare case of t-AML with plasmacytoid dendritic cells (pDC-AML) developing after FCR treatment for CLL that was successfully treated with haplotransplantation. Case Presentation: A 57-year-old woman with CLL-B was treated with six cycles of FCR, achieving a complete response. Six years later, at age 63, she developed t-AML with a rare morphophenotypic subtype: acute myelomonocytic leukemia with plasmacytoid dendritic cells (pDC-AML) and monosomy 8. Diagnostic challenges included distinguishing this subtype from blastic plasmacytoid dendritic cell neoplasm (BPDCN). She was treated with high-dose cytarabine followed by haploidentical stem cell transplantation from her son. Haploidentical transplantation was prioritized due to the urgent clinical need in a patient with high-risk acute leukemia (therapy-related leukemia secondary to prior chemoimmunotherapy and failure to achieve complete remission following the standard 3 + 7 induction protocol). In this critical setting, the patient\u2019s son was immediately available as an HLA-haploidentical donor. Prior to the performance of the haploidentical stem cell transplant from her son, no HLA-matched unrelated donor (MUD) could be identified. Another viable alternative would have been the utilization of umbilical cord blood-derived stem cells harvested from the patient\u2019s twin granddaughters. She was closely monitored post-transplant for potential complications, including graft-versus-host disease (GVHD), post-transplant lymphoproliferative disorder, and thyroid dysfunction, all of which were ruled out during follow-up. The patient remains in complete remission 15 years after her initial CLL diagnosis and 8 years after the t-AML diagnosis and haplotransplantation. Notably, no residual CLL clone was detected at the time of t-AML development, and a benign polyclonal lymphocytosis observed between 2018 and 2020 spontaneously resolved without intervention. Conclusions: This case illustrates the potential for long-term survival in high-risk patients with therapy-related AML developed after cytotoxic treatment for lymphoid malignancies. Haplotransplantation from a semi-identical Human Leukocyte Antigen (HLA) donor proved to be a viable and effective treatment option despite the patient\u2019s age and dual hematologic malignancies.<\/jats:p>","DOI":"10.3390\/jcm15041559","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T08:38:39Z","timestamp":1771231119000},"page":"1559","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and Long-Term Remission Following Haploidentical HSCT for Therapy-Related Acute Myelomonocytic Leukemia with Plasmacytoid Dendritic Cells Post-FCR Therapy for CLL: A Case Report"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2806-2688","authenticated-orcid":false,"given":"Alina Camelia","family":"Catana","sequence":"first","affiliation":[{"name":"County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania"},{"name":"Faculty of Medicine Sibiu, Lucian Blaga University of Sibiu, Lucian Blaga, 2A, 550169 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1036-8922","authenticated-orcid":false,"given":"Lidia-Maria","family":"Mondoc","sequence":"additional","affiliation":[{"name":"County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania"},{"name":"Faculty of Medicine Sibiu, Lucian Blaga University of Sibiu, Lucian Blaga, 2A, 550169 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4392-8522","authenticated-orcid":false,"given":"Maria-Gabriela","family":"Vladoiu","sequence":"additional","affiliation":[{"name":"County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania"},{"name":"Faculty of Medicine Sibiu, Lucian Blaga University of Sibiu, Lucian Blaga, 2A, 550169 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsofia","family":"Varady","sequence":"additional","affiliation":[{"name":"Fundeni Clinical Insitute, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camelia","family":"Dobrea","sequence":"additional","affiliation":[{"name":"Fundeni Clinical Insitute, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7987-9106","authenticated-orcid":false,"given":"Horia Mihail","family":"Sandu","sequence":"additional","affiliation":[{"name":"Fundeni Clinical Insitute, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Mocanu","sequence":"additional","affiliation":[{"name":"County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariela","family":"Olteanu","sequence":"additional","affiliation":[{"name":"County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geanina","family":"Mera","sequence":"additional","affiliation":[{"name":"County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1121-3788","authenticated-orcid":false,"given":"Minodora","family":"Teodoru","sequence":"additional","affiliation":[{"name":"County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania"},{"name":"Faculty of Medicine Sibiu, Lucian Blaga University of Sibiu, Lucian Blaga, 2A, 550169 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"ref_1","unstructured":"American Cancer Society (2024, August 01). 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