Early peripheral blood and T-cell chimerism dynamics after umbilical cord blood transplantation supported with haploidentical cells

• Published in: Bone marrow transplantation (Basingstoke) Vol. 49; no. 2; pp. 212 - 218
• Main Authors: Kwon, M, Martínez-Laperche, C, Balsalobre, P, Serrano, D, Anguita, J, Gayoso, J, Díez-Martín, J L, Buño, I
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.02.2014; Nature Publishing Group
• Subjects: 631/250; 692/700/565/545/576/1955; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood; Bone marrow; Bone marrow, stem cells transplantation. Graft versus host reaction; Care and treatment; CD34 antigen; Cell Biology; Chimerism; Cohort Studies; Complications; Cord blood; Cord Blood Stem Cell Transplantation - methods; Diagnosis; Disease-Free Survival; Dynamics; Female; Fetal blood; Graft rejection; Graft versus host reaction; Grafts; Haploidy; Health aspects; Hematology; Histocompatibility antigen HLA; Humans; Internal Medicine; Lymphocytes; Lymphocytes T; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Neutropenia; original-article; Peripheral blood; Public Health; Stem cell research; Stem cell transplantation; Stem Cells; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation Conditioning - methods; Transplantation, Homologous - methods; Transplants; Transplants & implants; Umbilical cord; Young Adult; chimerism; graft failure; cord blood transplantation; haploidentical donor; Haploidentical graft; Hematology; Stem cell; Hematopoietic cell; Homograft; Graft failure; Blood cell; Donor; Dynamics; T-Lymphocyte; Early; Chimerism; Umbilical cord
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2013.177

Single-unit umbilical cord blood (CB) SCT is limited by low total nucleated cell (TNC) dose. Co-infusion of CD34+ cells from a third party HLA-mismatched donor, known as dual or haplo-cord transplant, reduces the period of post-transplant neutropenia and related complications. The aim of this study was to analyze the value of early post-transplant peripheral blood (PB) and T cell chimerism after 28 dual transplants regarding CB engraftment. Cumulative incidence of myeloid engraftment at 30 days was 93% with a median time to engraftment of 14 days (10–29). Patients who developed CB graft failure ( n =5) showed very low percentages of CB cells on days +14, +21 and +28 with decreasing dynamics. On the other hand, percentages of CB cells in patients who achieved CB engraftment increased over time. Interestingly, such patients showed two distinct chimerism dynamics in PB, but all of them showed a predominance of CB T cells early after SCT with increasing dynamics over time. Early post-transplant chimerism dynamics in PB and T cells predicts CB graft failure enabling rapid therapeutic measures to be applied. On the other hand, early increasing percentages of CB T cells correlates with ultimate CB engraftment.