Prognostic Utility of Routine Chimerism Testing at 2 to 6 Months After Allogeneic Hematopoietic Cell Transplantation

Overview

Journal Biol Blood Marrow Transplant

Date 2009 Feb 11

PMID 19203726

Citations 9

Authors

Ghada I Mossallam

Azza M Kamel

Barry Storer

Paul J Martin

Affiliations

Soon will be listed here.

Abstract

The utility of routine chimerism analysis as a prognostic indicator of subsequent outcomes after allogeneic hematopoietic cell transplantation (HCT) with myeloablative conditioning regimens remains controversial. To address this controversy, routine chimerism test results at 2 to 6 months after HCT with myeloablative conditioning regimens were evaluated for association with subsequent risk of chronic graft-versus-host disease (GVHD), nonrelapse mortality (NRM), relapse, and overall mortality. Only 70 of 1304 patients (5%) had < 95% donor-derived cells in the marrow. Low donor chimerism in the marrow occurred more often in patients with low-risk diseases compared with those with higher-risk diseases and was significantly associated with a reduced risk of chronic GVHD. Among 673 patients evaluated, 164 (24%) had < 85% donor-derived T cells in the blood. Low donor T cell chimerism was more frequent in patients with low-risk diseases compared with those with higher-risk diseases, in those who received conditioning with busulfan compared with those who received conditioning with total body irradiation, and in those with lower-grade acute GVHD. Low donor T cell chimerism in the blood was significantly associated with a reduced risk of chronic GVHD but not with a reduced risk of relapse, NRM, or overall mortality. Routine testing of chimerism in the marrow and blood at 2 to 6 months after HCT with myeloablative conditioning regimens may be helpful in documenting engraftment in clinical trials, but provides only limited prognostic information in clinical practice.

Citing Articles

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Impact of early chimerism status on clinical outcome in children with acute lymphoblastic leukaemia after haematopoietic stem cell transplantation.

Lejman M, Zaucha-Prazmo A, Zawitkowska J, Mroczkowska A, Grabowski D, Kowalczyk J BMC Cancer. 2019; 19(1):1141.

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The Relationship between STR-PCR Chimerism Analysis and Chronic GvHD Following Hematopoietic Stem Cell Transplantation.

Mousavi S, Javadimoghadam M, Ghavamzadeh A, Alimoghaddam K, Sayarifard A, Ghaffari S Int J Hematol Oncol Stem Cell Res. 2017; 11(1):24-29.

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Dynamical System Modeling to Simulate Donor T Cell Response to Whole Exome Sequencing-Derived Recipient Peptides Demonstrates Different Alloreactivity Potential in HLA-Matched and -Mismatched Donor-Recipient Pairs.

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