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Kinetics of peripheral blood chimerism for surveillance of patients with leukemia and chronic myeloid malignancies after reduced-intensity conditioning allogeneic hematopoietic SCT

Bone Marrow Transplantation volume 50, pages 743–745 (2015)Cite this article

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Chimerism is universally used to monitor engraftment after hematopoietic SCT (HSCT); it is valuable for predicting graft failure, rejection as well as relapses in malignant diseases. Chimerism kinetics are clinically significant and are influenced by the type of conditioning regimens and transplanted diseases. After reduced-intensity conditioning (RIC), dynamics to reach full donor chimerism seem to be slower compared with myeloablative conditioning; however, most patients obtain full chimerism within the first 6 months.1 Underlying diseases might influence significantly the kinetics of chimerism. In aplastic anemia, stable mixed chimerism provided similar survival advantage to complete donor chimerism compared with progressive mixed chimerism;2 however, in AML conditioned with myeloablative or RIC, full donor chimerism is related with a lower risk of relapse and mortality.3 Knowledge of the clinical significance of chimerism kinetics over >1 year after RIC–HSCT is scarce; hence, we aimed to evaluate in a population transplanted due myeloid neoplasms, the impact on outcome of chimerism kinetics.

All patients with acute leukemia or chronic myeloid neoplasm transplanted with RIC between 1998 and 2013 at the Hematology Division of the University of Basel (Basel, Switzerland) were included in this retrospective study. After allogeneic HSCT, all recipients were regularly followed up at 1, 3, 6 and 12 months, and thereafter at yearly intervals or more often when indicated. These consultations included assessment of past history, clinical examination, standard laboratory tests and chimerism of peripheral blood. Leukocyte subpopulation chimerism of CD+ (T lymphocytes) and CD66+ (granulocytes) cells was performed in patients without full donor chimerism or under persistent immunosuppression. Patients provided written informed consent to have their data reported in an anonymous way to the register. Clinical surveillance of HSCT recipients was approved by the local Institutional Review Board. Patient characteristics, HSCT conditioning regimens and clinical outcome data were collected prospectively and stored in the local institution database registry.

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References

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Acknowledgements

We thank the Molecular Biology Team and the Flow Cytometry Team of the Hematology Laboratory of the University Hospital of Basel for their great contribution in this study.

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Authors and Affiliations

  1. Hematology Division, University Hospital of Basel, Basel, Switzerland

    L Eggimann, S Girsberger, J Halter, S Gerull, A Tichelli, H Baldomero, D Heim, J Passweg & A Rovó

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  1. L Eggimann
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  2. S Girsberger
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  3. J Halter
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  4. S Gerull
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  5. A Tichelli
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  6. H Baldomero
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  7. D Heim
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  8. J Passweg
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  9. A Rovó
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Correspondence to A Rovó.

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Eggimann, L., Girsberger, S., Halter, J. et al. Kinetics of peripheral blood chimerism for surveillance of patients with leukemia and chronic myeloid malignancies after reduced-intensity conditioning allogeneic hematopoietic SCT. Bone Marrow Transplant 50, 743–745 (2015). https://doi.org/10.1038/bmt.2015.3

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