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Mixed donor chimaerism in recipient fingernails following reduced-intensity conditioning haematopoietic SCT

Bone Marrow Transplantation volume 42, pages 361–362 (2008)Cite this article

Monitoring engraftment of donor haematopoietic cells post transplant may be carried out through donor and patient genotyping using short tandem repeat (STR) markers. In the reduced-intensity conditioning (RIC) transplant setting, sublineage chimaerism has been shown to be a useful tool in monitoring engraftment, predicting relapse and guiding immunotherapy (such as donor lymphocyte infusions).1 Recently, there has been much interest surrounding the potential development of donor-derived haematopoietic cells in non-haematopoietic tissue following allogeneic haematopoietic SCT (HSCT). By performing chimaerism studies on isolated non-haematopoietic tissue such as fingernail or hair follicle samples, several groups have demonstrated the presence of mixed donor–recipient chimaerism in fingernail samples of patients who had undergone conventional myeloablative HSCT.2, 3 Clinical effects of myeloablative HSCT often include significant tissue inflammation and damage, and it has been hypothesized that these conditions may facilitate the engraftment of donor-derived stem cells in non-haematopoietic tissue.2 It remains unclear at present whether similar patterns of mixed donor chimaerism may be found in patients undergoing non-myeloablative conditioning regimens.

We report herein on the results of eight sets of matched fingernail and peripheral blood (PB) chimaerism studies performed on adult patients undergoing allogeneic HSCT (Table 1). Two patients received conventional myeloablative conditioning and six received an RIC transplant for a range of haematological malignancies (myelodysplastic syndrome, AML). The median age of the patients at transplant was 51 years (range: 28–66 years) and four patients had prior cutaneous GVHD. The median time of fingernail chimaerism sampling was 1048 days post-HSCT (range: 68–3353 days). None of the patients had active GVHD at time of sampling, and there was no abnormalities in the growth and appearance of fingernails in any of the patients tested, or any evidence of recent trauma or bleeding.

Table 1 Chimerism results from all eight patients analysed (fingernail, unfractionated PB, CD3 lineage, CD15 lineage)
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References

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Authors and Affiliations

  1. Department of Haematological Medicine, Kings College London, London, UK

    L Pearce, Z Y Lim, M Usai, A Y L Ho, G J Mufti & A Pagliuca

  2. Kings College Hospital NHS Foundation Trust, London, UK

    L Pearce, Z Y Lim, M Usai, A Y L Ho, G J Mufti & A Pagliuca

Authors
  1. L Pearce
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  2. Z Y Lim
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  3. M Usai
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  4. A Y L Ho
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  5. G J Mufti
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  6. A Pagliuca
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Correspondence to A Pagliuca.

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Pearce, L., Lim, Z., Usai, M. et al. Mixed donor chimaerism in recipient fingernails following reduced-intensity conditioning haematopoietic SCT. Bone Marrow Transplant 42, 361–362 (2008). https://doi.org/10.1038/bmt.2008.176

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