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Debate Round Table on Chimerism

Lineage-specific chimaerism after stem cell transplantation in children following reduced intensity conditioning: potential predictive value of NK cell chimaerism for late graft rejection

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Abstract

Chimaerism of FACS-sorted leucocyte subsets (CD14+, CD15+, CD3−/56+, CD3+/4+, CD3+/8+, CD19+) was monitored prospectively between days +14 and +100 in 39 children undergoing allogeneic stem cell transplantation with reduced intensity-conditioning regimens. Cell subsets exceeding 1% of nucleated cells were subject to cell sorting. Chimaerism was analysed by dual-colour FISH and/or by short tandem repeat-polymerase chain reaction. The chimaerism pattern on day +28 was evaluated with regard to its correlation with graft rejection. Of 39 patients, nine patients had donor chimaerism (DC) in all subsets. Mixed/recipient chimaerism (MC/RC) was detectable within T cells in 62%, within NK cells in 39% and within monocytes and granulocytes in 38% of the patients. The correlation of secondary graft rejection with the chimaerism pattern on day +28 revealed the strongest association between RC in NK-cells (P<0.0001), followed by T cells (P=0.001), and granulocytes and monocytes (P=0.034). Notably, patients with RC in T cells rejected their graft only if MC or RC was also present in the NK-cell subset. By contrast, none of the children with DC in NK cells experienced a graft rejection. These observations suggest that, in the presence of recipient T-cell chimaerism, the chimaerism status in NK-cells on day +28 might be able to identify patients at high risk for late graft rejection.

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Authors and Affiliations

  1. St Anna Children's Hospital, Vienna, Austria

    S Matthes-Martin, C Peters, A Lawitschka & H Gadner

  2. Children's Cancer Research Institute, Vienna, Austria

    T Lion, O A Haas, H Daxberger, M König, D Printz, D Scharner, C Eichstill, H Gadner & G Fritsch

  3. Department of Medical Statistics, University of Vienna, Vienna, Austria

    F Frommlet

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  1. S Matthes-Martin
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  2. T Lion
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Matthes-Martin, S., Lion, T., Haas, O. et al. Lineage-specific chimaerism after stem cell transplantation in children following reduced intensity conditioning: potential predictive value of NK cell chimaerism for late graft rejection. Leukemia 17, 1934–1942 (2003). https://doi.org/10.1038/sj.leu.2403087

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