Early CD3+/CD15+ peripheral blood leukocyte chimerism patterns correlate with long-term engraftment in non-malignant hematopoietic SCT

Bone Marrow Transplant. 2014 Apr;49(4):572-5. doi: 10.1038/bmt.2013.207. Epub 2014 Jan 13.

Abstract

Following hematopoietic SCT (HSCT) for non-malignant disorders (NMDs) variable donor chimerism among lympho-hematopoietic lines may be observed. We retrospectively evaluated early post-HSCT, lineage-sorted (CD3+ and CD15+) peripheral blood leukocyte chimerism data to characterize patterns and assess for association with long-term CD15+ engraftment. 'Early' was defined as the first value obtained between days +14 and +42, 'late' as the last recorded value after day +90. 'High' donor chimerism was defined as 80% on either fraction at all time-points. Patients were classified into four subgroups with respect to early CD3+/CD15+ chimerism patterns (high/low) then analyzed for long-term CD15+ chimerism status. A total of 135 transplants were evaluable, with all three time-points available in 97. Underlying disease, graft source, patient age and conditioning intensity varied. 'Split' early chimerism (discordant high/low CD3+/CD15+ status) was common. Multivariable analysis revealed strong association between conditioning regimen and primary disease on early CD3+/CD15+ chimerism patterns and a dominant predictive effect of early CD15+ chimerism on long-term CD15+ donor engraftment (observed at median day +365). These data may guide real-time clinician decisions (restraint vs intervention, when available) when faced with unfavorable or unusual early lympho-hematopoietic chimerism patterns following HSCT for NMD.

MeSH terms

  • Adolescent
  • Adult
  • CD3 Complex / blood*
  • CD3 Complex / immunology
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Leukocytes / immunology*
  • Lewis X Antigen / blood*
  • Lewis X Antigen / immunology
  • Male
  • Transplantation Chimera / blood*
  • Transplantation Chimera / immunology
  • Transplantation, Homologous / methods*
  • Young Adult

Substances

  • CD3 Complex
  • Lewis X Antigen