Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Keil, F; Prinz, E; Moser, K; Mannhalter, C; Kalhs, P; Worel, N; Rabitsch, W; Schulenburg, A; Mitterbauer, M; Greinix, H.
Rapid establishment of long-term culture-initiating cells of donor origin after nonmyeloablative allogeneic hematopoietic stem-cell transplantation, and significant prognostic impact of donor T-cell chimerism on stable engraftment and progression-free survival.
Transplantation. 2003; 76(1):230-236
Doi: 10.1097/01.TP.0000071862.42835.76
Web of Science
PubMed
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FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Greinix Hildegard
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- Abstract:
- Nonmyeloablative allogeneic hematopoietic stem-cell transplantation (NST) allows establishment of donor hematopoiesis without eradication of recipient stem cells by chemoradiotherapy. Quantification of donor chimerism may predict graft failure and relapse. We quantified donor long-term culture-initiating cells (LTC-IC) in nine patients during the early phase after NST and lineage-specific donor cells of myeloid (CD33+, CD34+, granulocytes) and lymphoid lineage (CD3+, CD4+, CD8+, CD56+) in 38 patients with a median follow-up of 40 weeks after NST. Conditioning therapy consisted of fludarabine 90 mg/m2 followed by total body irradiation of 2 Gy. Only rapid establishment of donor T-cell chimerism was essential for stable donor engraftment. Patients with less than 90% of donor T cells 4 weeks after NST had a significantly higher risk of relapse, graft rejection, or both (14 of 18 patients) than patients with donor T-cell chimerism of 90% and higher (3 of 20 patients). Although conditioning therapy was nonmyeloablative, a significant decrease of repopulating stem cells defined as LTC-IC was seen after 2 weeks followed by rapid recovery of LTC-IC to pretransplant values. Interestingly, all LTC-IC were from donor origin 2 and 4 weeks after NST, but rapid establishment of donor LTC-IC was not predictive for progression-free survival. Rapid establishment of lymphoid but not myeloid donor chimerism is a prognostic factor for stable donor engraftment after NST. It seems that an immunologic shield of alloreactive donor T cells is essential for early hematopoietic progenitors.
- Find related publications in this database (using NLM MeSH Indexing)
- ABO Blood-Group System -
- Adolescent -
- Adult -
- Aged -
- Antigens, CD - blood
- Blood Group Incompatibility -
- Cell Culture Techniques - methods
- Disease-Free Survival -
- Female -
- Graft vs Host Disease - prevention & control
- Hematopoietic Stem Cells - cytology
- Humans -
- Immunosuppressive Agents - therapeutic use
- In Situ Hybridization, Fluorescence -
- Leukemia - therapy
- Male -
- Middle Aged -
- Neoplasms - therapy
- Prognosis -
- Stem Cell Transplantation - methods
- T-Lymphocytes - immunology
- Tissue Donors -
- Transplantation Chimera - immunology
- Transplantation, Autologous -
- Transplantation, Homologous -
- Treatment Outcome -