Kinetics of engraftment in patients with hematologic malignancies given allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning.

Blood
Frédéric BaronMarie-Térèse Little

Abstract

We analyzed the kinetics of donor engraftment among various peripheral blood cell subpopulations and their relationship to outcomes among 120 patients with hematologic malignancies given hematopoietic cell transplantation (HCT) after nonmyeloablative conditioning consisting of 2 Gy total body irradiation (TBI) with or without added fludarabine. While patients rapidly developed high degrees of donor engraftment, most remained mixed donor/host chimeras for up to 180 days after HCT. Patients given preceding chemotherapies and those given granulocyte colony-stimulating factor-mobilized peripheral blood mononuclear cell (G-PBMC) grafts had the highest degrees of donor chimerism. Low donor T-cell (P = .003) and natural killer (NK) cell (P = .004) chimerism levels on day 14 were associated with increased probabilities of graft rejection. High T-cell chimerism on day 28 was associated with an increased probability of acute graft-versus-host disease (GVHD) (P = .02). Of 93 patients with measurable malignant disease at transplantation, 41 achieved complete remissions a median of 199 days after HCT; 19 of the 41 were mixed T-cell chimeras when complete remissions were achieved. Earlier establishment of donor NK-cell chimerism was associat...Continue Reading

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Citations

Jan 5, 2006·The Journal of Experimental Medicine·Matthew P CollinAnne M Dickinson
Feb 4, 2011·Annals of Oncology : Official Journal of the European Society for Medical Oncology·S TerakuraUNKNOWN Nagoya Blood and Marrow Transplantation Group
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Apr 21, 2012·Current Opinion in Hematology·Mark BoschJan Storek
Jan 20, 2007·Blood·H Joachim Deeg
Feb 9, 2012·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Rachel B SalitMichael R Bishop
Oct 20, 2006·International Journal of Hematology·Miwa SakaiHisashi Sakamaki
Mar 13, 2014·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Jonathan BenjaminRobert Lowsky
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Sep 10, 2005·Bone Marrow Transplantation·A GratwohlUNKNOWN Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation

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