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Allografting

CD34+ cell dose, conditioning regimen and prior chemotherapy: factors with significant impact on the early kinetics of donor chimerism after allogeneic hematopoietic cell transplantation

Bone Marrow Transplantation volume 34, pages 949–954 (2004)Cite this article

Summary:

The aim of this study was to define factors that significantly influence the early kinetics of donor chimerism after transplantation. In a retrospective study, the percentage of donor chimerism in peripheral blood measured with sex-chromosome-specific probes and fluorescence–in situ hybridization was analyzed in 184 recipients of allogeneic hematopoietic cells between days 1 and 30. Using a generalized linear model for longitudinal observations, the dose of CD34+ cells infused had a significant impact on the slope of donor chimerism. In multivariate analysis, cell doses of 2–8 × 106/kg (P=0.001) and <2 × 106 CD34+ cells/kg (P<0.0001) were associated with slower increase of donor chimerism compared to >8.0 × 106 CD34+ cells/kg. In addition, fludarabine-based reduced-intensity conditioning resulted in a significant delay of donor cell increase compared to standard conditioning therapy (P=0.0001). The application of chemotherapy before the start of conditioning (P=0.0003) and the use of antithymocyte globulin (P=0.003) were associated with a faster increase of donor chimerism. The factors identified in this study can be used to predict the kinetics of early donor chimerism for an individual patient.

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Acknowledgements

We thank the nurses and physicians of the transplant unit for the dedicated patient care. We lso extend our special thanks to Ulrike Ehrenlechner, Jeanneatte Mundt, Elvira Thomsen and Ulrike Fitze for the cytogenetic preparations and FISH analyses. We acknowledge Catrin Theuser for data management. This study was supported in part by the Deutsche Krebshilfe Bonn (Grant-No. 70-2755 to CT and MB).

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany

    B Mohr, C Thiede, F Kroschinsky, G Ehninger & M Bornhäuser

  2. Institut für Medizinische Informatik und Biometrie, Universitätsklinikum Carl Gustav Carus, Dresden, Germany

    R Koch

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  1. B Mohr
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  2. R Koch
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  3. C Thiede
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  4. F Kroschinsky
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  5. G Ehninger
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  6. M Bornhäuser
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Correspondence to M Bornhäuser.

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Mohr, B., Koch, R., Thiede, C. et al. CD34+ cell dose, conditioning regimen and prior chemotherapy: factors with significant impact on the early kinetics of donor chimerism after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 34, 949–954 (2004). https://doi.org/10.1038/sj.bmt.1704710

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