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 journalArticlepeer-review

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

Keywords

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

ASJC Scopus subject areas

  • Hematology

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