Reference : Chimerism and outcomes after allogeneic hematopoietic cell transplantation following ...
Scientific journals : Other
Human health sciences : Hematology
Human health sciences : Oncology
Chimerism and outcomes after allogeneic hematopoietic cell transplantation following nonmyeloablative conditioning
Baron, Frédéric mailto [Université de Liège - ULg > Département des sciences cliniques > Hématologie]
Sandmaier, B. M. [> > > >]
Nature Publishing Group
Yes (verified by ORBi)
[en] hematopoietic cell transplantation ; nonmyeloablative conditioning ; donor chimerism ; T-cells ; NK cells
[en] Allogeneic hematopoietic cell transplantation ( HCT) following nonmyeloablative conditioning has been extensively evaluated in patients with hematologic malignancies who are ineligible for conventional HCT because of age or medical comorbidities. Nonmyeloablative regimens have led to an initial state of mixed hematopoietic chimerism defined as coexistence of donor- and host-derived hematopoiesis. While nonmyeloablative regimens have been associated with reduced regimen-related toxicities in comparison with conventional myeloablative conditioning, graft rejection, graft-versus-host disease ( GVHD), and disease progression have remained significant challenges. In this article, after briefly introducing current techniques for chimerism assessment, we describe factors affecting donor chimerism levels after nonmyeloablative conditioning, and then review data suggesting that chimerism assessment early after HCT might help identify patients at risk for graft rejection, GVHD and relapse/progression. Finally, we discuss how these observations have opened the way to further research protocols evaluating manipulation of postgrafting immunosuppression, and/or infusion of donor immune cells.

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