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Non-myeloablative stem cell transplantation (NST): chimerism testing as guidance for immune-therapeutic manipulations

Leukemia volume 15, pages 1967–1975 (2001)Cite this article

Chimera in the ancient Greek mythology was a fire-breathing monster that had the head of a lion, the body of a she-goat, and the tail of a dragon. In modern allogeneic stem cell transplantation chimerism describes the presence of donor hematopoietic and lymphoid cells in a transplant recipient. Full donor or complete chimerism (CC) is defined when all hematopoietic and lymphoid cells in the transplant recipient derive from the donor. Mixed chimerism (MC) describes the persistence of host and donor cells together. MC describes a dynamic balance between host and donor hematopoietic cells due to bilateral tolerance. MC may be stable or may be a transient phase following transplantation ultimately leading to CC or to graft rejection. Non-myeloablative stem cell transplantation (NST) represents one of the most significant recent advances in allogeneic transplantation. This approach intends to induce MC as a means to reduce toxicity, and as a platform for allogeneic adoptive cellular immunotherapy.

In this review, we discuss the rationale of the NST approach and the currently investigational NST regimens. We describe how MC affects transplantation outcomes, and how chimerism testing can be used to guide therapeutic interventions following NST.

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  1. Department of Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel

    A Shimoni & A Nagler

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Shimoni, A., Nagler, A. Non-myeloablative stem cell transplantation (NST): chimerism testing as guidance for immune-therapeutic manipulations. Leukemia 15, 1967–1975 (2001). https://doi.org/10.1038/sj.leu.2402316

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