Very early lineage-specific chimerism after reduced intensity stem cell transplantation is highly predictive of clinical outcome for patients with myeloid disease.

Abstract

BACKGROUND:

The importance of chimerism status in the very early period after hematopoietic stem cell transplantation is unclear. We determined PBMC and T-cell donor chimerism 50 days after transplantation and related this to disease relapse and overall survival.

METHODS:

144 sequential patients underwent transplantation of which 90 had AML/MDS and 54 had lymphoma. 'Full donor chimerism' was defined as ≥99% donor cells and three patient groups were defined: 40% with full donor chimerism (FC) in both PBMC and T-cells; 25% with mixed chimerism (MC) within both compartments and 35% with 'split' chimerism (SC) characterised by full donor chimerism within PBMC and mixed chimerism within T-cells.

RESULTS:

In patients with myeloid disease a pattern of mixed chimerism (MC) was associated with a one year relapse rate of 45% and a five year overall survival of 40% compared to values of 8% and 75%, and 17% and 60%, for those with SC or FC respectively. The pattern of chimerism had no impact on clinical outcome for lymphoma.

CONCLUSION:

The pattern of lineage-specific chimerism at 50 days after transplantation is highly predictive of clinical outcome for patients with myeloid malignancy and may help to guide subsequent clinical management.

• Authors: Francesca A M Kinsella, Charlotte F Inman, Amy Gudger, Yuen T Chan, Duncan J Murray, Jianmin Zuo, Graham McIlroy, Sandeep Nagra, Jane Nunnick, Kathy Holder, Kerry Wall, Mike Griffiths, Charles Craddock, Emmanouil Nikolousis, Paul Moss, Ram Malladi
• Journal: Leukemia research (Leuk Res) Vol. 83 Pg. 106173 (08 2019) ISSN: 1873-5835 [Electronic] England
• PMID: 31276965 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2019. Published by Elsevier Ltd.

Topics

• Adult
• Aged
• Allografts
• Disease-Free Survival
• Female
• Hematopoietic Stem Cell Transplantation
• Humans
• Leukemia, Myeloid, Acute (blood, mortality, therapy)
• Lymphoma (blood, mortality, therapy)
• Male
• Middle Aged
• Myelodysplastic Syndromes (blood, mortality, therapy)
• Survival Rate
• T-Lymphocytes (metabolism)
• Transplantation Chimera (blood)