Natural history of mixed chimerism after bone marrow transplantation with CD6-depleted allogeneic marrow: a stable equilibrium.

摘要: Mixed hematopoietic chimerism (MC) is a common finding after allogeneic bone marrow transplantation (BMT), but the natural history of this phenomenon remains unclear. To understand evolution and implications finding, we performed prospective analysis development mixed in 43 patients with hematologic malignancies who received (BM) from human leukocyte antigen (HLA)-identical sibling donors. T-cell depletion vitro anti-T12 (CD6) monoclonal antibody rabbit complement was used as only method graft-versus-host disease (GVHD) prophylaxis. Overall, MC identified peripheral blood (PB) BM 22 (51%) evaluated. found by restriction fragment length polymorphism (RFLP) 21 40 (53%) patients, cytogenetic 6 29 (21%) red cell phenotyping 4 9 (44%) patients. RFLP studies were at 0.5, 1, 3, 6, 9, 12 months post-BMT then every months, showed high probability developing first BMT followed stabilization months. Cytogenetic less sensitive detecting MC. Once detected BMT, percentage recipient cells increased very slowly over more than 3 years follow-up, no patient reverted to complete donor hematopoiesis (CDH). Thus, remained relative state equilibrium for prolonged periods that seemed favor cells. Patient's disease, remission status, or intensity transplant preparative regimen did not influence subsequent chimerism. Early immunologic reconstitution factor correlated chimeric status The absolute number T3 (CD3) T4 (CD4) positive day 14 significantly higher maintained CDH NK similar both groups, suggesting early T may play role preventing recovery BMT. GVHD also associated maintenance CDH, relapse, survival, disease-free survival identical CDH.