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Open Access 01-12-2019 | Acute Lymphoblastic Leukemia | Research article

Impact of early chimerism status on clinical outcome in children with acute lymphoblastic leukaemia after haematopoietic stem cell transplantation

Authors: Monika Lejman, Agnieszka Zaucha-Prażmo, Joanna Zawitkowska, Aleksandra Mroczkowska, Dominik Grabowski, Jerzy R. Kowalczyk, Katarzyna Drabko

Published in: BMC Cancer | Issue 1/2019

Abstract

Background

The significance of very early chimerism assessment before day + 28, which is considered the moment of engraftment, is still unclear. In this retrospective study, we evaluated the clinical impact of very early chimerism on the clinical outcome after allogeneic haematopoietic stem cell transplantation (allo-HSCT) in children with acute lymphoblastic leukaemia (ALL).

Methods

The study group included 38 boys and 18 girls. Very early chimerism was evaluated on days + 7, + 14, + 21 and + 28 after the transplant. Short tandem repeat polymerase chain reaction (STR PCR) was used to analyse chimerism.

Results

Overall survival (OS) and event-free survival (EFS) were 84 and 80%, respectively. The OS in the group of 24 patients with complete donor chimerism on day + 14 was 83%, and it did not differ statistically compared to the 32 patients with mixed chimerism on day + 14 (OS was 84%). In our cohort of patients, the matched unrelated donor, male gender of donor, number of transplanted cells above 4.47 × 10⁶ kg and no serotherapy with anti-thymocyte globulin (ATG) were statistically related to a higher level of donor chimerism. The immunophenotypes of disease, age of patient at time HSCT, recipient sex, stem cell source (peripheral blood/bone marrow) and conditioning regimen had no impact on early chimerism. Acute graft versus host disease grades II-IV was diagnosed in 23 patients who presented with donor chimerism levels above 60% on day 7.

Conclusions

The data presented in this study provide valuable insight into the analysis of very early chimerism in children with ALL treated with HSCT.

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Title: Impact of early chimerism status on clinical outcome in children with acute lymphoblastic leukaemia after haematopoietic stem cell transplantation
Authors: Monika Lejman
Agnieszka Zaucha-Prażmo
Joanna Zawitkowska
Aleksandra Mroczkowska
Dominik Grabowski
Jerzy R. Kowalczyk
Katarzyna Drabko
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Acute Lymphoblastic Leukemia
Graft-Versus-Host Disease
Graft-Versus-Host Disease
Stem Cell Transplantation
Stem Cell Transplantion
Stem Cell Transplantation
Published in: BMC Cancer / Issue 1/2019
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-019-6360-3

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