Francesca A M Kinsella1, Charlotte F Inman2, Amy Gudger3, Yuen T Chan2, Duncan J Murray2, Jianmin Zuo2, Graham McIlroy4, Sandeep Nagra4, Jane Nunnick4, Kathy Holder3, Kerry Wall5, Mike Griffiths6, Charles Craddock4, Emmanouil Nikolousis3, Paul Moss7, Ram Malladi1. 1. School of Cancer Sciences, University of Birmingham, Birmingham, UK; Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK. 2. School of Cancer Sciences, University of Birmingham, Birmingham, UK. 3. Heartlands Hospital, Heart of England NHS Foundation trust, Birmingham, UK. 4. Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK. 5. West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK. 6. School of Cancer Sciences, University of Birmingham, Birmingham, UK; West Midlands Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK. 7. 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.
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: Katie Maurer; Haesook T Kim; Thomas M Kuczmarski; Heather M Garrity; Augustine Weber; Carol G Reynolds; Deborah Liney; Corey Cutler; Joseph H Antin; John Koreth; Jerome Ritz; Roman M Shapiro; Rizwan Romee; Catherine J Wu; Robert J Soiffer; Sarah Nikiforow; Vincent T Ho; Mahasweta Gooptu Journal: Blood Adv Date: 2021-12-14