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

Research output: Contribution to journalArticlepeer-review

Authors

  • Amy Gudger
  • Graham McIlroy
  • Sandeep Nagra
  • Jane Nunnick
  • Kathy Holder
  • Kerry Wall
  • Mike Griffiths
  • Charles Craddock
  • Emmanouil Nikolousis
  • Paul Moss
  • Ram Malladi

External organisations

  • School of Cancer Sciences, University of Birmingham, Birmingham, UK; Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK.
  • Cancer Research Clinical Trials Unit, School of Cancer Sciences, University of Birmingham, Birmingham, United Kingdom.
  • Renal Department, Birmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UK. khaiping@doctors.org.uk
  • Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust and Birmingham Health Partners, Birmingham, United Kingdom; and.
  • West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, United Kingdom.
  • School of Cancer Sciences, University of Birmingham, Birmingham, UK; West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK.
  • School of Cancer Sciences, University of Birmingham, Birmingham, UK; Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK. Electronic address: p.moss@bham.ac.uk.

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.

Bibliographic note

Copyright © 2019. Published by Elsevier Ltd.

Details

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

Keywords

  • Chimerism, AML, Allogeneic-HSCT, Relapse