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Long-Term Mixed Chimerism After Ex Vivo / In Vivo T Cell-Depleted Allogeneic Hematopoietic Cell Transplantation in Patients With Myeloid Neoplasms.
- Source :
- Frontiers in Oncology; 12/7/2021, Vol. 11, p1-9, 9p
- Publication Year :
- 2021
-
Abstract
- In patients who have undergone allogeneic hematopoietic cell transplantation (HCT), myeloid mixed donor chimerism (MC) is a risk factor for disease relapse. In contrast, several studies found favorable outcome in patients with lymphoid MC. Thus far, most studies evaluating MC focused on a short-term follow-up period. Here, we report the first case series of long-term survivors with MC. We screened 1,346 patients having undergone HCT for myeloid neoplasms at our center from 1996 to 2016; 443 patients with data on total peripheral blood mononuclear cells (PBMC)/CD4<superscript>+</superscript>/CD34<superscript>+</superscript> short tandem repeat (STR) donor chimerism (DC) and follow-up ≥24 months post-HCT were included. We identified 10 patients with long-term MC (PBMC DC <95% at ≥12 months post-HCT). Median follow-up was 11 years. All patients had received combined ex vivo/in vivo T cell-depleted (TCD) peripheral blood stem cells; none experienced ≥grade 2 acute graft-versus-host disease (GVHD). The mean total PBMC, CD4<superscript>+</superscript>, and CD34<superscript>+</superscript> DC of all patients were 95.88%, 85.84%, and 90.15%, respectively. Reduced-intensity conditioning (RIC) was associated with a trend to lower mean total DC. Of note, two patients who experienced relapse had lower CD34<superscript>+</superscript> DC but higher CD4<superscript>+</superscript> DC as compared with patients in continuous remission. Bone marrow evaluation revealed increased CD4<superscript>+</superscript>/FOXP3<superscript>+</superscript> cells in patients with MC, which might indicate expansion of regulatory T cells (T<subscript>regs</subscript>). Our results support known predictive factors associated with MC such as RIC and TCD, promote the value of CD34<superscript>+</superscript> MC as a potential predictor of relapse, highlight the potential association of CD4<superscript>+</superscript> MC with reduced risk of GVHD, and indicate a possible role of T<subscript>regs</subscript> in the maintenance of immune tolerance post-HCT. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 2234943X
- Volume :
- 11
- Database :
- Complementary Index
- Journal :
- Frontiers in Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 154009214
- Full Text :
- https://doi.org/10.3389/fonc.2021.776946