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

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

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Pages (from-to)1859-1867
Number of pages9
JournalHaematologica
Volume93
Issue number12
DOIs
Publication statusPublished - Dec 2008

Fingerprint

Chimerism
Thalassemia
Fetal Blood
Siblings
Tissue Donors
Transplants
Bone Marrow
Transplantation
Unrelated Donors
Microsatellite Repeats

Keywords

  • β-thalassemia
  • Cord blood transplantation
  • Donor/recipient mixed chimerism
  • Graft failure
  • MC
  • Tolerance

ASJC Scopus subject areas

  • Hematology

Cite this

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

In: Haematologica, Vol. 93, No. 12, 12.2008, p. 1859-1867.

Research output: Contribution to journalArticle

Lisini, Daniela ; Zecca, Marco ; Giorgiani, Giovanna ; Montagna, Daniela ; Cristantielli, Rosaria ; Labirio, Massimo ; Grignani, Pierangela ; Previderè, Carlo ; Di Cesare-Merlone, Alessandra ; Amendola, Giovanni ; Bergami, Elena ; Mastronuzzi, Angela ; Maccario, Rita ; Locatelli, Franco. / 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. In: Haematologica. 2008 ; Vol. 93, No. 12. pp. 1859-1867.
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abstract = "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.",
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AU - Lisini, Daniela

AU - Zecca, Marco

AU - Giorgiani, Giovanna

AU - Montagna, Daniela

AU - Cristantielli, Rosaria

AU - Labirio, Massimo

AU - Grignani, Pierangela

AU - Previderè, Carlo

AU - Di Cesare-Merlone, Alessandra

AU - Amendola, Giovanni

AU - Bergami, Elena

AU - Mastronuzzi, Angela

AU - Maccario, Rita

AU - Locatelli, Franco

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N2 - 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.

AB - 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.

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KW - Cord blood transplantation

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KW - Graft failure

KW - MC

KW - Tolerance

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