Evaluation of Chimerism Dynamics after Allogeneic Hematopoietic Stem Cell Transplantation in Children with Nonmalignant Diseases

Maura Faraci, Francesca Bagnasco, Massimiliano Leoni, Stefano Giardino, Paola Terranova, Lorenzo Subissi, Marco Di Duca, Daniela Di Martino, Edoardo Lanino

Research output: Contribution to journalArticle

Abstract

It is recognized that chimerism following hematopoietic stem cell transplantation (HSCT) is a dynamic process. The aims of this study were to describe the evolution of chimerism in children with nonmalignant diseases who underwent allogeneic HSCT, and to analyze the risk factors influencing chimerism status. A total of 101 HSCTs were performed in 85 patients with nonmalignant diseases. The donor was unrelated in 62.4% of HSCTs. Reduced-intensity conditioning (RIC) regimen was administered in 48.5% of patients. Acute graft-versus-host disease (aGVHD) occurred in 51.7% and chronic GVHD (cGVHD) in 39.7% of patients. Analysis of chimerism was performed through amplification of 9 specific short tandem repeats by polymerase chain reaction at engraftment and 1, 6, and 12 months after HSCT. Upon first evaluation, complete chimerism (CC) was detected in 34.7% and mixed chimerism (MC) in 55.4%, whereas graft failure occurred in 9.9% of patients. Severe aGVHD was associated with CC (P =.031). The last chimerism evaluation showed CC in 72.1%, stable MC in 12.8%, and progressive MC in 3.5%. CC was associated with a higher incidence of aGVHD (P =.016) and cGVHD (P =.022), whereas the RIC regimen was associated with graft failure (P =.026). One- and 3-year overall survival (OS) was 87.4% and 80.5%, respectively, with a lower OS at 3 years in patients with CC compared with those with MC (P =.008). aGVHD and cGVHD represent factors favoring CC, thus close, careful follow-up of chimerism is recommended in patients affected by nonmalignant disease.

Original languageEnglish
Pages (from-to)1088-1093
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume24
Issue number5
DOIs
Publication statusPublished - May 1 2018

Keywords

  • Bone marrow transplantation
  • Chimerism
  • Graft-versus-host disease
  • Nonmalignant disease

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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