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Transplant Technology

Early CD3+/CD15+ peripheral blood leukocyte chimerism patterns correlate with long-term engraftment in non-malignant hematopoietic SCT

Bone Marrow Transplantation volume 49, pages 572–575 (2014)Cite this article

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Abstract

Following hematopoietic SCT (HSCT) for non-malignant disorders (NMDs) variable donor chimerism among lympho-hematopoietic lines may be observed. We retrospectively evaluated early post-HSCT, lineage-sorted (CD3+ and CD15+) peripheral blood leukocyte chimerism data to characterize patterns and assess for association with long-term CD15+ engraftment. ‘Early’ was defined as the first value obtained between days +14 and +42, ‘late’ as the last recorded value after day +90. ‘High’ donor chimerism was defined as ⩾80% on either fraction at all time-points. Patients were classified into four subgroups with respect to early CD3+/CD15+ chimerism patterns (high/low) then analyzed for long-term CD15+ chimerism status. A total of 135 transplants were evaluable, with all three time-points available in 97. Underlying disease, graft source, patient age and conditioning intensity varied. ‘Split’ early chimerism (discordant high/low CD3+/CD15+ status) was common. Multivariable analysis revealed strong association between conditioning regimen and primary disease on early CD3+/CD15+ chimerism patterns and a dominant predictive effect of early CD15+ chimerism on long-term CD15+ donor engraftment (observed at median day +365). These data may guide real-time clinician decisions (restraint vs intervention, when available) when faced with unfavorable or unusual early lympho-hematopoietic chimerism patterns following HSCT for NMD.

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Acknowledgements

The article represents original research and analysis. It has not been submitted elsewhere, nor previously published. All authors have contributed to the manuscript in significant ways, have reviewed and agreed upon the manuscript content.

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Authors and Affiliations

  1. Internal Medicine/Pediatrics, University of Minnesota, Minneapolis, MN, USA

    T G Ketterl

  2. Pediatric Blood and Marrow Transplant, University of Minnesota, Minneapolis, MN, USA

    M Flesher & W Miller

  3. Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA

    R Shanley

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  1. T G Ketterl
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  2. M Flesher
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Correspondence to T G Ketterl.

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Ketterl, T., Flesher, M., Shanley, R. et al. Early CD3+/CD15+ peripheral blood leukocyte chimerism patterns correlate with long-term engraftment in non-malignant hematopoietic SCT. Bone Marrow Transplant 49, 572–575 (2014). https://doi.org/10.1038/bmt.2013.207

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