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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Prognostic Utility of Routine Chimerism Testing at 2 to 6 Months after Allogeneic Hematopoietic Cell Transplantation
Biology of Blood and Marrow Transplantation, Volume 15, No. 3, Year 2009
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Description
The utility of routine chimerism analysis as a prognostic indicator of subsequent outcomes after allogeneic hematopoietic cell transplantation (HCT) with myeloablative conditioning regimens remains controversial. To address this controversy, routine chimerism test results at 2 to 6 months after HCT with myeloablative conditioning regimens were evaluated for association with subsequent risk of chronic graft-versus-host disease (GVHD), nonrelapse mortality (NRM), relapse, and overall mortality. Only 70 of 1304 patients (5%) had < 95% donor-derived cells in the marrow. Low donor chimerism in the marrow occurred more often in patients with low-risk diseases compared with those with higher-risk diseases and was significantly associated with a reduced risk of chronic GVHD. Among 673 patients evaluated, 164 (24%) had < 85% donor-derived T cells in the blood. Low donor T cell chimerism was more frequent in patients with low-risk diseases compared with those with higher-risk diseases, in those who received conditioning with busulfan compared with those who received conditioning with total body irradiation, and in those with lower-grade acute GVHD. Low donor T cell chimerism in the blood was significantly associated with a reduced risk of chronic GVHD but not with a reduced risk of relapse, NRM, or overall mortality. Routine testing of chimerism in the marrow and blood at 2 to 6 months after HCT with myeloablative conditioning regimens may be helpful in documenting engraftment in clinical trials, but provides only limited prognostic information in clinical practice. © 2009 American Society for Blood and Marrow Transplantation.
Authors & Co-Authors
Mossallam, Ghada Ibrahim
Egypt, Giza
Cairo University
Kamel, Azza Mahmoud
Egypt, Giza
Cairo University
Storer, Barry E.
United States, Seattle
Fred Hutchinson Cancer Research Center
United States, Seattle
University of Washington School of Medicine
Martin, Paul J.
United States, Seattle
Fred Hutchinson Cancer Research Center
United States, Seattle
University of Washington School of Medicine
Statistics
Citations: 7
Authors: 4
Affiliations: 3
Identifiers
Doi:
10.1016/j.bbmt.2008.12.496
ISSN:
10838791
e-ISSN:
15236536