Details

Autor(en) / Beteiligte

• Lisini, Daniela
• Zecca, Marco
• Giorgiani, Giovanna
• Montagna, Daniela
• Cristantielli, Rosaria
• Labirio, Massimo
• Grignani, Pierangela
• Previdere, Carlo
• Di Cesare-Merlone, Alessandra
• Amendola, Giovanni
• Bergami, Elena
• Mastronuzzi, Angela
• Maccario, Rita
• Locatelli, Franco

Titel

Donor/recipient mixed chimerism does not predict graft failure in children with {beta}-thalassemia given an allogeneic cord blood transplant from an HLA-identical sibling

Ist Teil von

• Haematologica (Roma), 2008-12, Vol.93 (12), p.1859-1867

Erscheinungsjahr

2008

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• 1 Oncoematologia Pediatrica, Laboratorio di Immunologia dei Trapianti, Fondazione IRCCS Policlinico San Matteo, Pavia 2 Dipartimento di Scienze Pediatriche, Università di Pavia 3 Laboratorio di Ematologia Forense, Istituto di Medicina Legale, Università di Pavia 4 Unità di Pediatria, Ospedale di Nocera Inferiore, Italy Correspondence: Daniela Lisini, Oncoematologia Pediatrica, Laboratorio di Immunologia dei Trapianti, Fondazione IRCCS Policlinico San Matteo, P.le Golgi, 2, I-27100 Pavia, Italy. E-mail: d.lisini{at}smatteo.pv.it Background: Donor/recipient mixed chimerism has been reported to be associated with an increased risk of graft failure in patients with β-thalassemia given a bone marrow transplant. We investigated the relationship between the degree of mixed chimerism over time and clinical outcome of children undergoing cord blood transplantation for β-thalassemia. Design and Methods: Twenty-seven consecutive children given a cord blood transplant from a related donor were analyzed by short tandem repeat polymerase chain reaction and their chimerism results were compared with those of 79 consecutive patients who received a bone marrow transplant from either a relative (RD-BMT, n=42) or an unrelated donor (UD-BMT, n=37). Cord blood and bone marrow recipients received comparable preparative regimens. Results: All cord blood recipients engrafted and displayed mixed chimerism early after transplantation; 13/27 converted to full donor chimerism over time, while 14 maintained stable mixed chimerism; all patients are alive and transfusion-independent. Twenty-four of the 79 bone marrow-recipients (12 UD- and 12 RD-BMT) exhibited full donor chimerism at all time points examined, 4/79 (2 UD- and 2 RD-BMT) did not engraft and 51/79 (23 UD- and 28 RD-BMT) displayed mixed chimerism at the time of hematologic reconstitution. Forty of 51 bone marrow recipients with mixed chimerism converted to full donor chimerism (17 UD- and 23 RD-BMT), 3/51 maintained stable mixed chimerism (1 UD- and 2 RD-BMT), while 8/51 (5 UD- and 3 RD-BMT) progressively lost the graft, and became transfusion-dependent again. Conclusions: Mixed chimerism is a frequent event and does not predict the occurrence of graft failure in children with β-thalassemia given a cord blood transplant from a relative. Key words: cord blood transplantation, β-thalassemia, donor, recipient mixed chimerism, MC, graft failure, tolerance.