Donor Chimerism Early after Reduced-Intensity Conditioning Hematopoietic Stem Cell Transplantation Predicts Relapse and Survival

Abstract The impact of early donor cell chimerism on outcomes of T cell–replete reduced-intensity conditioning (RIC) hematopoietic stem cell transplantation (HSCT) is ill defined. We evaluated day 30 (D30) and 100 (D100) total donor cell chimerism after RIC HSCT undertaken between 2002 and 2010 at o...

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Bibliographic Details
Published in:Biology of blood and marrow transplantation 2014-10, Vol.20 (10), p.1516-1521
Main Authors: Koreth, John, Kim, Haesook T, Nikiforow, Sarah, Milford, Edgar L, Armand, Philippe, Cutler, Corey, Glotzbecker, Brett, Ho, Vincent T, Antin, Joseph H, Soiffer, Robert J, Ritz, Jerome, Alyea, Edwin P
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Allogeneic transplantation
Chimerism
Female
Graft Survival
Hematologic Neoplasms - diagnosis
Hematologic Neoplasms - immunology
Hematologic Neoplasms - mortality
Hematologic Neoplasms - therapy
Hematology, Oncology and Palliative Medicine
Hematopoietic Stem Cell Transplantation
Histocompatibility Testing
Humans
Male
Middle Aged
Myeloablative Agonists - therapeutic use
Prognosis
Recurrence
Reduced-intensity
Retrospective Studies
Survival Analysis
T-Lymphocytes - immunology
T-Lymphocytes - pathology
Tissue Donors
Transplantation Chimera - genetics
Transplantation Chimera - immunology
Transplantation Conditioning - methods
Transplantation, Homologous
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Summary:Abstract The impact of early donor cell chimerism on outcomes of T cell–replete reduced-intensity conditioning (RIC) hematopoietic stem cell transplantation (HSCT) is ill defined. We evaluated day 30 (D30) and 100 (D100) total donor cell chimerism after RIC HSCT undertaken between 2002 and 2010 at our institution, excluding patients who died or relapsed before D30. When available, donor T cell chimerism was also assessed. The primary outcome was overall survival (OS). Secondary outcomes included progression-free survival (PFS), relapse, and nonrelapse mortality (NRM). We evaluated 688 patients with hematologic malignancies (48% myeloid and 52% lymphoid) and a median age of 57 years (range, 18 to 74) undergoing RIC HSCT with T cell–replete donor grafts (97% peripheral blood; 92% HLA-matched), with a median follow-up of 58.2 months (range, 12.6 to 120.7). In multivariable analysis, total donor cell and T cell chimerism at D30 and D100 each predicted RIC HSCT outcomes, with D100 total donor cell chimerism most predictive. D100 total donor cell chimerism
ISSN:1083-8791
1523-6536
DOI:10.1016/j.bbmt.2014.05.025