Details

Autor(en) / Beteiligte

• Ruhnke, Leo
• Stölzel, Friedrich
• Oelschlägel, Uta
• von Bonin, Malte
• Sockel, Katja
• Middeke, Jan Moritz
• Röllig, Christoph
• Jöhrens, Korinna
• Schetelig, Johannes
• Thiede, Christian
• Bornhäuser, Martin

Titel

Long-Term Mixed Chimerism After Ex Vivo / In Vivo T Cell-Depleted Allogeneic Hematopoietic Cell Transplantation in Patients With Myeloid Neoplasms

Ist Teil von

• Frontiers in oncology, 2021-12, Vol.11, p.776946-776946

Ort / Verlag

Switzerland: Frontiers Media S.A

Erscheinungsjahr

2021

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• In patients who have undergone allogeneic hematopoietic cell transplantation (HCT), myeloid mixed donor chimerism (MC) is a risk factor for disease relapse. In contrast, several studies found favorable outcome in patients with lymphoid MC. Thus far, most studies evaluating MC focused on a follow-up period. Here, we report the first case series of survivors with MC. We screened 1,346 patients having undergone HCT for myeloid neoplasms at our center from 1996 to 2016; 443 patients with data on total peripheral blood mononuclear cells (PBMC)/CD4 /CD34 short tandem repeat (STR) donor chimerism (DC) and follow-up ≥24 months post-HCT were included. We identified 10 patients with MC (PBMC DC <95% at ≥12 months post-HCT). Median follow-up was 11 years. All patients had received combined T cell-depleted (TCD) peripheral blood stem cells; none experienced ≥grade 2 acute graft-versus-host disease (GVHD). The mean total PBMC, CD4 , and CD34 DC of all patients were 95.88%, 85.84%, and 90.15%, respectively. Reduced-intensity conditioning (RIC) was associated with a trend to lower mean total DC. Of note, two patients who experienced relapse had lower CD34 DC but higher CD4 DC as compared with patients in continuous remission. Bone marrow evaluation revealed increased CD4 /FOXP3 cells in patients with MC, which might indicate expansion of regulatory T cells (T ). Our results support known predictive factors associated with MC such as RIC and TCD, promote the value of CD34 MC as a potential predictor of relapse, highlight the potential association of CD4 MC with reduced risk of GVHD, and indicate a possible role of T in the maintenance of immune tolerance post-HCT.