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

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

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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.

Original languageEnglish
Article number106173
Number of pages7
JournalLeukemia Research
Volume83
Early online date18 Jun 2019
DOIs
Publication statusPublished - 1 Aug 2019

Bibliographical note

Copyright © 2019. Published by Elsevier Ltd.

Keywords

  • Chimerism
  • AML
  • Allogeneic-HSCT
  • Relapse

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