Post-transplant T cell chimerism predicts graft versus host disease but not disease relapse in patients undergoing an alemtuzumab based reduced intensity conditioned allogeneic transplant

作者：Nikolousis E^*; Robinson S; Nagra S; Brookes C; Kinsella F; Tauro S; Jeffries S; Griffiths M; Mahendra P; Cook M; Paneesha S; Lovell R; Kishore B; Chaganti S; Malladi R; Raghavan M; Moss P; Milligan D; Craddock C

来源：Leukemia Research, 2013, 37(5): 561-565.

DOI：10.1016/j.leukres.2013.01.010

• Reduced intensity transplant
• T cell chimerism
• Alemtuzumab

In this multicentre retrospective study we have studied the impact of T cell chimerism on the outcome of 133 patients undergoing an alemtuzumab based reduced intensity conditioning allograft (RIC). The median age of the patients was 50 years (range 42-55 years). 77 patients were transplanted using an HLA identical sibling donor while 56 patients received a fully matched volunteer unrelated donor graft. 64 patients had a lymphoid malignancy and 69 were transplanted for a myeloid malignancy. 38 patients (29%) relapsed with no significant difference in risk of relapse between patients developing full donor and mixed donor chimerism in the T-cell compartment on D + 90 and D + 180 post transplant. Day 90 full donor T cell chimerism correlated with an increased incidence of acute GVHD according to NIH criteria (p = 0.0004) and the subsequent development of chronic GVHD. Consistent with previous observations, our results confirmed a correlation between the establishment of T cell full donor chimerism and acute GVHD in T deplete RIC allografts. However our study failed to identify any correlation between T cell chimerism and relapse risk and challenge the use of pre-emptive donor lymphocyte infusions (DLI) in patients with mixed T cell chimerism transplanted using an alemtuzumab based RIC regimen.

• 出版日期2013-5