+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Mixed hematologic chimerism after allogeneic marrow transplantation for severe aplastic anemia is associated with a higher risk of graft rejection and a lessened incidence of acute graft-versus-host disease



Mixed hematologic chimerism after allogeneic marrow transplantation for severe aplastic anemia is associated with a higher risk of graft rejection and a lessened incidence of acute graft-versus-host disease



Blood 67(3): 811-816



Ninety-six patients with severe aplastic anemia who received a sex-mismatched, HLA-identical allogeneic sibling marrow transplant had sequential cytogenetic analyses performed to determine the incidence and implications of posttransplant mixed hematologic chimerism. Of the 96 patients, 56 (58.3%) became mixed chimeras with coexisting host and donor cells detected in peripheral blood or marrow 14 days or later after transplant, and 40 patients (41.7%) were complete chimeras with 100% donor-type hematopoietic cells. The incidence of mixed chimerism was independent of prior blood production transfusions and infusion of donor buffy coat. The rejection rate was significantly increased in the mixed chimeric group, particularly in patients not receiving buffy coat (14 of 36 rejecting), although overall, the majority (69.7%) retained their first graft. Rejection was seen almost exclusively in patients exposed to multiple transfusions before transplantation. If patients who reject their first graft are censored, the overall incidence of grades II through IV acute graft-v-host disease (GVHD) was significantly reduced in those with mixed chimerism. Transfused patients with mixed chimerism in particular were less likely to develop grades II through IV acute GVHD. The incidence of chronic GVHD was similar in the two groups and did not significantly influence survival. In this study, mixed chimerism persisted for up to 395 days posttransplant, either the first graft being rejected or, more commonly, hematopoiesis reverting to 100% donor-type cells. Mixed lymphohematopoietic chimerism may persist in patients with aplastic anemia who have received matched allogeneic marrow transplants for significant periods before hematopoiesis reverts to donor cell type.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 040710256

Download citation: RISBibTeXText

PMID: 3511988


Related references

Previous donor pregnancy as a risk factor for acute graft versus host disease in patients with aplastic anemia treated by allogeneic marrow transplantation. British Journal of Haematology 74(4): 492-496, 1990

Serial chimerism analyses indicate that mixed haemopoietic chimerism influences the probability of graft rejection and disease recurrence following allogeneic stem cell transplantation (SCT) for severe aplastic anaemia (SAA): indication for routine assessment of chimerism post SCT for SAA. British Journal of Haematology 144(6): 933-945, 2009

Effect of mixed chimerism on graft-versus-host disease, disease recurrence and survival after HLA-identical marrow transplantation for aplastic anemia or chronic myelogenous leukemia. Bone Marrow Transplantation 18(4): 767-776, 1996

Prediction by a modified mixed leukocyte reaction assay of graft-versus-host disease and graft rejection after allogeneic bone marrow transplantation. Transplantation 57(10): 1474-1479, 1994

Acute graft-versus-host disease and the risks for idiopathic pneumonia after marrow transplantation for severe aplastic anemia. Bone Marrow Transplantation 12(3): 225-231, 1993

Impact of prophylactic donor leukocyte infusions on mixed chimerism, graft-versus-host disease, and antitumor response in patients with advanced hematologic malignancies treated with nonmyeloablative conditioning and allogeneic bone marrow transplantation. Biology of Blood and Marrow Transplantation 9(5): 320-329, 2003

Bone marrow transplantation for severe aplastic anemia effects of immunosuppressive treatment regimen on graft failure graft versus host disease interstitial pneumonitis and survival. Champlin, R E And R P Gale (Ed ) Ucla (University Of California-Los Angeles) Symposia on Molecular And Cellular Biology New Series, Vol 137 New Strategies in Bone Marrow Transplantation; Sandoz-Ucla Symposium, Keystone, Colorado, Usa, January 20-27, 1990 Xxiii+457p Wiley-Liss: New York, New York, Usa; Chichester, England, Uk Illus 87-92, 1991

Cyclophosphamide plus busulfan in preparation for allogeneic bone marrow transplantation in patients with severe aplastic anemia and high-risk of graft rejection. Blood 84(10 Suppl. 1): 204A, 1994

Chimaerism studies following allogeneic bone marrow transplantation for severe aplastic anaemia may help predict those patients at higher risk of graft rejection. Experimental Hematology 26(8): 785, 1998

Decreased incidence of acute and chronic Graft vs Host Disease following primary transplantation of allogeneic peripheral blood stem cells in patients with severe aplastic anemia. Blood 96(11 Part 1): 400a, 2000

Campath-1G in vivo confers a low incidence of graft-versus-host disease associated with a high incidence of mixed chimaerism after bone marrow transplantation for severe aplastic anaemia using HLA-identical sibling donors. Bone Marrow Transplantation 17(5): 819-824, 1996

Mixed chimerism after allogeneic marrow transplantation for leukemia correlation with dose of total body irradiation and graft versus host disease. Bone Marrow Transplantation 5(4): 235-240, 1990

Clinical and hematologic response of chronic lymphocytic and prolymphocytic leukemia persisting after allogeneic bone marrow transplantation with the onset of acute graft-versus-host disease: possible role of graft-versus-leukemia. Bone Marrow Transplantation 17(3): 371-375, 1996

T cell mixed chimerism is significantly correlated to a decreased risk of acute graft-versus-host disease after allogeneic stem cell transplantation. Transplantation 71(3): 433-439, 2001

Omission of day 11 methotrexate does not appear to influence the incidence of moderate to severe acute graft-versus-host disease, chronic graft-versus-host disease, relapse rate or survival after HLA-identical sibling bone marrow transplantation. Bone Marrow Transplantation 16(6): 755-758, 1995