Evaluation of Clinical Outcome and Mixed Chimerism Follow-up after Allogeneic Hematopoietic Stem Cell Transplantation in Hematological Malignancies
Objective: The level of donor-recipient chimerism is an established method to document donor engraftment. Allogeneic stem cell transplantation(ASCT) may result in mixed hematopoietic chimerism (MC), especially after reduced intensity conditioning regimens. Increasing MC levels in the post ASCT perio...
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Veröffentlicht in: | Gazi tıp dergisi 2020-01, Vol.31 (1), p.52-55 |
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Sprache: | eng |
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Zusammenfassung: | Objective: The level of donor-recipient chimerism is an established method
to document donor engraftment. Allogeneic stem cell transplantation(ASCT)
may result in mixed hematopoietic chimerism (MC), especially after reduced
intensity conditioning regimens. Increasing MC levels in the post ASCT period
may indicate disease relapse, graft failure, or rejection. In this study we
aimed to study clinical outcome of mixed chimerism after ASCT in patients
with hematological diseases.
Methods: The data of 335 patients whose ASCT were performed at our
center between 2009 and 2019 and survived more than three months after
transplantation were analyzed retrospectively.
Results: During follow up period 127 (43%) of 293 patients in full chimeric
(FC) group and 11 (26.1%) of 42 patients in MC group died. 11 patients
received donor lymphocyte infusions (DLI) after MC detected, 4 of them
converted into FC. 10 mix chimeric patients converted into FC spontaneously.
In 3 patients no donor cell was observed in time (0%). 2 of them are still in
remission. 25 patients remained mix chimeric during follow up period. 66
patients received reduced intensity conditioning (RIC) regimen and 10
(15.1%) of them had MC during follow up period. 269 patients received
myeloablative conditioning (MAC) regimen and 32 (11.8%) of them had MC
during follow up period.
Conclusion: ASCT may result in MC especially after RIC regimens. MC does
not always related with relapse risk and mix chimeric patients with malignant
or benign hematological diseases can stay in remission for a long time. |
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ISSN: | 2147-2092 2147-2092 |
DOI: | 10.12996/gmj.2020.13 |