Published online 22 October 2008
Haematologica, Vol 93, Issue 12, 1859-1867 doi:10.3324/haematol.13248
Copyright © 2008 by Ferrata Storti Foundation
Daniela Lisini1 ,
Marco Zecca1 ,
Giovanna Giorgiani1 ,
Daniela Montagna2 ,
Rosaria Cristantielli1 ,
Massimo Labirio1 ,
Pierangela Grignani3 ,
Carlo Previderè3 ,
Alessandra Di Cesare-Merlone1 ,
Giovanni Amendola4 ,
Elena Bergami1 ,
Angela Mastronuzzi1 ,
Rita Maccario1 ,
Franco Locatelli1,2
Haematologica, Vol 93, Issue 12, 1859-1867 doi:10.3324/haematol.13248
Copyright © 2008 by Ferrata Storti Foundation
Stem Cell Transplantation |
Donor/recipient mixed chimerism does not predict graft failure in children with β-thalassemia given an allogeneic cord blood transplant from an HLA-identical sibling
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.
This article has been cited by other articles:
 |
|
 |
|
  G. Serafini, M. Andreani, M. Testi, M. Battarra, A. Bontadini, E. Biral, K. Fleischhauer, S. Marktel, G. Lucarelli, M. G. Roncarolo, et al. Type 1 regulatory T cells are associated with persistent split erythroid/lymphoid chimerism after allogeneic hematopoietic stem cell transplantation for thalassemia Haematologica, October 1, 2009; 94(10): 1415 - 1426. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Angelucci and D. Baronciani Allogeneic stem cell transplantation for thalassemia major Haematologica, December 1, 2008; 93(12): 1780 - 1784. [Full Text] [PDF]
|
|