Condition
Includes all haematological and non-haematological malignancies, but excludes benign tumours.
Individual at risk
Recipient
Guidance at RECRUITMENT for adult volunteer donor and maternal donor (cord blood donation)
UNACCEPTABLE, except completely treated basal cell carcinoma of the skin and cured in-situ carcinoma (see below).
Guidance at CT/WORK-UP
UNACCEPTABLE, but see below.
Donors with malignancy or with a history of malignancy must not donate.
There are two exceptions from this:
1. Cured carcinoma in-situ. In the EU, legislation limits this category to cervical carcinoma in-situ, whereas in other countries cured localized squamous cell carcinoma of the skin cancer, breast cancer in-situ and bladder cancer in-situ might also be acceptable.
2. Successfully and completely treated basal cell carcinoma
Women with known positivity for BRCA1 or 2 but no history of cancer are acceptable as donors. All such women should have a breast examination performed at work-up.
In the above cases, these conditions must always be communicated to the requesting transplant centre.
Justification for guidance
There is a risk of transmission of malignancy to the recipient.
Melanoma in-situ found in younger people, typical of the age of donors, are uncommon but have a reported recurrence rate of 5%. Such patients are at a higher risk of developing melanoma in other locations. In addition, melanoma has been proven to be transmissible by organ transplantation.
References
Gandhi MJ, Strong DM. Donor derived malignancy following transplantation: a review. Cell Tissue Bank 2007; 8(4): 267-86.
Otero L, de Souza DC, de Cassia Tavares R, Gomes BE, Padilha TF, Bouzas LF et al. Monosomy 7 in donor cell-derived leukemia after bone marrow transplantation for severe aplastic anemia: Report of a new case and review of the literature. Genet Mol Biol 2012; 35(4): 734-6.
Browne PV, Lawler M, Humphries P, McCann SR. Donor-cell leukemia after bone marrow transplantation for severe aplastic anemia. N Engl J Med 1991; 325(10): 710-3.
See also Project Notify