Abstract
We prospectively studied the chimaerism status in the bone marrow (BM) and peripheral blood (PB) of 23 patients receiving umbilical cord (UCB, 14 cases) or BM (nine cases) transplants from unrelated donors by PCR amplification of four individual-specific VNTR genetic loci. Haematological engraftment, with persistent full donor pattern, was observed in 10/14 (72%) patients receiving UCB and in 9/9 (100%) patients transplanted with marrow from an unrelated donor (MUD). In contrast, the remaining four patients converted to an autologous pattern. Three out of these four patients had an early autologous haematological reconstitution reaching a neutrophil level >0.5 x 10 9/l at days 27, 33 and 37 after transplant, respectively. In all three of these patients, chimaerism analysis demonstrated an early appearance of donor cells (i.e. within 35 d after UCB transplant) showing a transient full donor (one case) or mixed chimaerism condition (two cases). Despite the early autologous haemopoietic reconstitution, one of the three patients died of GVHD at day 60, which was explained by the demonstration of low levels of donor lymphoid cells. In the MUD group all nine patients converted to a persistent full donor pattern with haematological reconstitution, accompanied in two of them by transient mixed chimaerism lasting to days 60 and 270 after transplant. Our data show that monitoring of chimaerism may predict graft failure with or without early autologous haemopoietic reconstitution in patients receiving unrelated UCB transplants. Furthermore, chimaerism analysis may identify, in patients with autologous reconstitution, those at risk of severe GVHD in whom immunosuppressive therapy should not be discontinued.
| Original language | English |
|---|---|
| Pages (from-to) | 770-777 |
| Number of pages | 8 |
| Journal | British Journal of Haematology |
| Volume | 104 |
| Issue number | 4 |
| Publication status | Published - 1999 |
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Keywords
- Bone marrow unrelated donor
- Chimaerism
- Early autologous haemopoietic reconstitution
- Graft failure
- Umbilical cord blood
ASJC Scopus subject areas
- Hematology
Cite this
A prospective molecular study of chimaerism in patients with haematological malignancies receiving unrelated cord blood or bone marrow transplants : Detection of mixed chimaerism predicts graft failure with or without early autologous reconstitution in cord blood recipients. / Cimino, Giuseppe; Rapanotti, Maria Cristina; Elia, Loredana; Iori, Anna Paola; Guglielmi, Cesare; Screnci, Maria; Carmini, Daniela; De Felice, Lidia; Moleti, Maria Luisa; Mengarelli, Andrea; Mandelli, Franco; Arcese, William.
In: British Journal of Haematology, Vol. 104, No. 4, 1999, p. 770-777.Research output: Contribution to journal › Article
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TY - JOUR
T1 - A prospective molecular study of chimaerism in patients with haematological malignancies receiving unrelated cord blood or bone marrow transplants
T2 - Detection of mixed chimaerism predicts graft failure with or without early autologous reconstitution in cord blood recipients
AU - Cimino, Giuseppe
AU - Rapanotti, Maria Cristina
AU - Elia, Loredana
AU - Iori, Anna Paola
AU - Guglielmi, Cesare
AU - Screnci, Maria
AU - Carmini, Daniela
AU - De Felice, Lidia
AU - Moleti, Maria Luisa
AU - Mengarelli, Andrea
AU - Mandelli, Franco
AU - Arcese, William
PY - 1999
Y1 - 1999
N2 - We prospectively studied the chimaerism status in the bone marrow (BM) and peripheral blood (PB) of 23 patients receiving umbilical cord (UCB, 14 cases) or BM (nine cases) transplants from unrelated donors by PCR amplification of four individual-specific VNTR genetic loci. Haematological engraftment, with persistent full donor pattern, was observed in 10/14 (72%) patients receiving UCB and in 9/9 (100%) patients transplanted with marrow from an unrelated donor (MUD). In contrast, the remaining four patients converted to an autologous pattern. Three out of these four patients had an early autologous haematological reconstitution reaching a neutrophil level >0.5 x 10 9/l at days 27, 33 and 37 after transplant, respectively. In all three of these patients, chimaerism analysis demonstrated an early appearance of donor cells (i.e. within 35 d after UCB transplant) showing a transient full donor (one case) or mixed chimaerism condition (two cases). Despite the early autologous haemopoietic reconstitution, one of the three patients died of GVHD at day 60, which was explained by the demonstration of low levels of donor lymphoid cells. In the MUD group all nine patients converted to a persistent full donor pattern with haematological reconstitution, accompanied in two of them by transient mixed chimaerism lasting to days 60 and 270 after transplant. Our data show that monitoring of chimaerism may predict graft failure with or without early autologous haemopoietic reconstitution in patients receiving unrelated UCB transplants. Furthermore, chimaerism analysis may identify, in patients with autologous reconstitution, those at risk of severe GVHD in whom immunosuppressive therapy should not be discontinued.
AB - We prospectively studied the chimaerism status in the bone marrow (BM) and peripheral blood (PB) of 23 patients receiving umbilical cord (UCB, 14 cases) or BM (nine cases) transplants from unrelated donors by PCR amplification of four individual-specific VNTR genetic loci. Haematological engraftment, with persistent full donor pattern, was observed in 10/14 (72%) patients receiving UCB and in 9/9 (100%) patients transplanted with marrow from an unrelated donor (MUD). In contrast, the remaining four patients converted to an autologous pattern. Three out of these four patients had an early autologous haematological reconstitution reaching a neutrophil level >0.5 x 10 9/l at days 27, 33 and 37 after transplant, respectively. In all three of these patients, chimaerism analysis demonstrated an early appearance of donor cells (i.e. within 35 d after UCB transplant) showing a transient full donor (one case) or mixed chimaerism condition (two cases). Despite the early autologous haemopoietic reconstitution, one of the three patients died of GVHD at day 60, which was explained by the demonstration of low levels of donor lymphoid cells. In the MUD group all nine patients converted to a persistent full donor pattern with haematological reconstitution, accompanied in two of them by transient mixed chimaerism lasting to days 60 and 270 after transplant. Our data show that monitoring of chimaerism may predict graft failure with or without early autologous haemopoietic reconstitution in patients receiving unrelated UCB transplants. Furthermore, chimaerism analysis may identify, in patients with autologous reconstitution, those at risk of severe GVHD in whom immunosuppressive therapy should not be discontinued.
KW - Bone marrow unrelated donor
KW - Chimaerism
KW - Early autologous haemopoietic reconstitution
KW - Graft failure
KW - Umbilical cord blood
UR - http://www.scopus.com/inward/record.url?scp=0033063935&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033063935&partnerID=8YFLogxK
M3 - Article
C2 - 10192439
AN - SCOPUS:0033063935
VL - 104
SP - 770
EP - 777
JO - British Journal of Haematology
JF - British Journal of Haematology
SN - 0007-1048
IS - 4
ER -