Immunological importance of chimerism in transplantation: new conditioning protocol in BMT and the development of chimeric state

• Published in: Human immunology Vol. 61; no. 2; pp. 101 - 110
• Main Authors: Barta, Anikó, Bátai, Árpád, Kelemen, Endre, Lengyel, Lilla, Reményi, Péter, Sipos, Andrea, Torbágyi, Éva, Avalos, Manuel, Fekete, Erika, Földi, János, Páldi-Haris, Piroska, Tamáska, Júlia, Gyódi, Éva, Rajczy, Katalin, Hoffer, Izabella, Jakab, Judit, Petrányi, Győző G, Pálóczi, Katalin
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2000
• Subjects: Antineoplastic Agents, Alkylating - pharmacology; bone marrow transplantation; Bone Marrow Transplantation - immunology; chimerism; chronic myeloid leukemia; conditioning; Cyclophosphamide - pharmacology; Cytarabine - pharmacology; Graft vs Host Disease - immunology; Humans; Immunosuppressive Agents - pharmacology; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - therapy; Mitobronitol - pharmacology; Transplantation Chimera - drug effects; Transplantation Chimera - immunology; Treatment Outcome; ALL; TCR; MHC; GVHD; bone marrow transplantation; DBM; Ph chromosome; PBSCT; Cy; chronic myeloid leukemia; TBI; VNTR; AML; CML; BCR-ABL; BMT; chimerism; Ara-C; SAA; conditioning; DNA; ALG; GVL; HLA; NK; PCR
• ISSN: 0198-8859; 1879-1166
• DOI: 10.1016/S0198-8859(99)00143-3

Chimerism is an exceptional immunogenetic state, characterized by the survival and collaboration of cell populations originated from two different individuals. The prerequisits to induce chimerism are immunosuppression, myeloablation, or severe immunodeficiency of the recipients on the one side and donor originated immuno-hematopoietic cells in the graft on the other. The pathologic or special immunogenetic conditions to establish chimerism are combined with bone marrow transplantation, transfusion, and various kinds of solid organ grafting. Different types of chimerism are known including complete, mixed and mosaic, or split chimerism. There are various methods used to detect the type of chimera state, depending on the immunogenetic differences between the donor and recipient. The induction of complete or mixed chimerism is first determinated by the effect of myeloablative therapy. The chimera state seems to be one of the leading factors to influence the course of the post-transplant period, the frequency and severity of GVHD, and the rate of relapse. However, the most important contribution of the chimeric state is in development of graft versus leukemia effect. A new conditioning protocol (DBM/Ara-C/Cy) for allogeneic BMT in CML patients and its consequence on chimera state and GVL effect is demonstrated.