Influence of conditioning regimens and stem cell sources on donor-type chimerism early after stem cell transplantation

Sato, Junichi; Tanaka, Junji; Hashimoto, Aya; Shiratori, Souichi; Yasumoto, Atsushi; Wakasa, Kentaro; Kikuchi, Misato; Shigematsu, Akio; Miura, Yoko; Tsutsumi, Yutaka; Kondo, Takeshi; Asaka, Masahiro; Imamura, Masahiro

doi:10.1007/s00277-008-0542-4

Cited by 13 publications

(12 citation statements)

References 26 publications

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“…The results reported here are similar to those reported by others. [2][3][4][5][6][7][12][13][14] These data undermine the use of the terms 'myeloablative' and 'nonmyeloablative'. As Deeg 15 has recently pointed out, all transplantations in patients with malignant hematological disorders are designed to be myeloablative in order to achieve disease eradication.…”

Section: Discussionmentioning

confidence: 98%

Comparison of donor chimerism following myeloablative and nonmyeloablative allogeneic hematopoietic SCT

Mickelson

Sproat

Dean

et al. 2010

Bone Marrow Transplant

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Surveillance of hematopoietic chimerism following hematopoietic SCT (HSCT) with nonmyeloablative (NMA) preparative regimens is standard to assess the need for clinical intervention. Monitoring of donor chimerism following HSCT with myeloablative (MA) preparative regimens is, however, not considered useful because engraftment is thought to occur rapidly and consistently. This study compares the timing of donor hematopoietic cell engraftment in patients undergoing NMA conditioning with fludarabine and TBI with those receiving MA conditioning with BU-or TBI-based regimens. Achievement of X90% donor leukocyte chimerism occurred rapidly and consistently in all three groups and time to achievement of X90% donor T cells was similar among the three groups (P ¼ 0.57). Achievement of X90% donor leukocyte chimerism was not associated with risk of acute or chronic GVHD, graft rejection, relapse or all cause mortality in multivariate analyses. Donor T-cell chimerism of X90% was significantly associated with development of extensive chronic GVHD. The value of routine surveillance of chimerism following any of the preparative regimens used in this study should be reevaluated.

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Section: Discussionmentioning

confidence: 98%

Comparison of donor chimerism following myeloablative and nonmyeloablative allogeneic hematopoietic SCT

Mickelson

Sproat

Dean

et al. 2010

Bone Marrow Transplant

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“…in divided doses daily for 2 days, total dose of 6.4 mg/kg) ? lowdose (2 or 4 Gy) TBI [16]. FLU/L-PAM consisted of fludarabine (30 mg/m 2 once daily i.v.…”

Section: Patients and Preparative Regimensmentioning

confidence: 99%

“…Cytogenetic abnormality is one of the most widely recognized risk factors in AML patients. AMLs with karyotype t(8;21), inv (16), t(16;16) and t (15;17) are expected to be controlled by chemotherapy alone, and patients with these AMLs are thus categorized into a favorable cytogenetic risk group [3]. For this reason, indication for allo-HSCT for patients in this group is considered not at the first complete remission (CR1) but at the state of relapse, after the second remission (CR2) or in the case of failure to achieve remission [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Successful treatment of acute myelogenous leukemia with favorable cytogenetics by reduced-intensity stem cell transplantation

et al. 2010

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Acute myelogenous leukemia (AML) with favorable cytogenetics responds well to chemotherapy. If the leukemia relapses, allogenic hematopoietic stem transplantation (allo-HSCT) is considered as a treatment option. Since the efficacy of reduced-intensity stem cell transplantation (RIST) for AML with favorable cytogenetics has not been established, we retrospectively analyzed the outcomes of allo-HSCT in AML patients according to cytogenetic risks. The outcome of allo-HSCT for AML patients with favorable cytogenetics seemed to be superior to that for AML patients with intermediate cytogenetics. In AML patients with favorable cytogenetics, the 3-year overall survival (OS) and relapse-free survival (RFS) rates were 88% and 76%, respectively, in the RIST group. Both the 3-year OS and RFS rates were 81% in the conventional stem cell transplantation (CST) group. The outcome of RIST for AML patients with favorable cytogenetics was comparable to that for patients who received CST despite the more advanced age and greater organ dysfunction in RIST group than in CST group. None of the patients died within 90 days after RIST. Moreover, there was no relapse in patients with favorable cytogenetics who were in hematological remission prior to RIST. Thus, RIST for AML patients with favorable cytogenetics in remission is safe and effective

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“…Thus, transplant characteristics should be considered when evaluating the results of chimerism analysis. Although numerous studies have performed chimerism analysis after allogeneic PBSCT with RIC regimens [9,10,14], only limited data are available regarding the chimerism status after allogeneic BMT with RIC regimens [13]. In Japan, peripheral blood stem cell donation from unrelated donors was not permitted until October, 2010.…”

Section: Introductionmentioning

confidence: 99%

“…The kinetics of chimerism are influenced by various transplant characteristics such as conditioning regimens and stem cell sources [7,9,12,13]. Thus, transplant characteristics should be considered when evaluating the results of chimerism analysis.…”

Section: Introductionmentioning

confidence: 99%

Chimerism status after unrelated donor bone marrow transplantation with fludarabine-melphalan conditioning is affected by the melphalan dose and is predictive of relapse

Imahashi¹,

Ohashi

Terakura

et al. 2015

Ann Hematol

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Little is known regarding the chimerism status after reduced-intensity conditioning transplantation when bone marrow is used as a stem cell source. We prospectively analyzed lineage-specific chimerism and retrospectively evaluated clinical outcomes in 80 adult patients who underwent unrelated donor bone marrow transplantation (URBMT) with fludarabine plus melphalan (FM) as the conditioning regimen. Mixed donor chimerism (MDC) was seen in 43 and 10 % of patients at days 14 and 28, respectively. Melphalan at ≤130 mg/m(2) was associated with an increased incidence of MDC at day 28 (P = 0.03). Patients with MDC at day 14 showed a marginally increased risk of primary graft failure and a marginally decreased risk of graft-versus-host disease. In multivariate analysis, MDC at day 14 was associated with higher overall mortality (hazard ratio (HR) = 2.1; 95 % confidence interval (CI), 1.1-4.2; P = 0.04) and relapse rate (HR = 3.0; 95 % CI, 1.2-7.5; P = 0.02), but not with non-relapse mortality (HR = 1.8; 95 % CI, 0.70-4.6; P = 0.23). Thus, the FM regimen yields prompt complete donor chimerism after URBMT, but the melphalan dose significantly impacts the kinetics of chimerism. Chimerism status evaluation at day 14 may be instrumental in predicting relapse after URBMT with the FM regimen.

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Influence of conditioning regimens and stem cell sources on donor-type chimerism early after stem cell transplantation

Cited by 13 publications

References 26 publications

Comparison of donor chimerism following myeloablative and nonmyeloablative allogeneic hematopoietic SCT

Comparison of donor chimerism following myeloablative and nonmyeloablative allogeneic hematopoietic SCT

Successful treatment of acute myelogenous leukemia with favorable cytogenetics by reduced-intensity stem cell transplantation

Chimerism status after unrelated donor bone marrow transplantation with fludarabine-melphalan conditioning is affected by the melphalan dose and is predictive of relapse

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