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Post-transplant T cell chimerism predicts graft versus host disease but not disease relapse in patients undergoing an alemtuzumab based reduced intensity conditioned allogeneic transplant.

Nikolousis, M and Robinson, S and Nagra, S and Brookes, C and Kinsella, F and Tauro, S and Jeffries, S and Griffiths, M and Mahendra, P and Cook, M and Paneesha, S and Lovell, R and Kishore, B and Chaganti, S and Malladi, R and Raghavan, M and Moss, P and Milligan, D and Craddock, C (2013) Post-transplant T cell chimerism predicts graft versus host disease but not disease relapse in patients undergoing an alemtuzumab based reduced intensity conditioned allogeneic transplant. Leukemia research, 37 (5). pp. 561-565. ISSN 1873-5835. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their Athens login IDs

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Official URL: http://www.sciencedirect.com/science/article/pii/S...

Abstract

In this multicentre retrospective study we have studied the impact of T cell chimerism on the outcome of 133 patients undergoing an alemtuzumab based reduced intensity conditioning allograft (RIC). The median age of the patients was 50 years (range 42-55 years). 77 patients were transplanted using an HLA identical sibling donor while 56 patients received a fully matched volunteer unrelated donor graft. 64 patients had a lymphoid malignancy and 69 were transplanted for a myeloid malignancy. 38 patients (29%) relapsed with no significant difference in risk of relapse between patients developing full donor and mixed donor chimerism in the T-cell compartment on D+90 and D+180 post transplant. Day 90 full donor T cell chimerism correlated with an increased incidence of acute GVHD according to NIH criteria (p=0.0004) and the subsequent development of chronic GVHD. Consistent with previous observations, our results confirmed a correlation between the establishment of T cell full donor chimerism and acute GVHD in T deplete RIC allografts. However our study failed to identify any correlation between T cell chimerism and relapse risk and challenge the use of pre-emptive donor lymphocyte infusions (DLI) in patients with mixed T cell chimerism transplanted using an alemtuzumab based RIC regimen.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their Athens login IDs
Subjects: WH Haemic and lymphatic systems. Haematology
Divisions: Clinical Support > Pathology
Planned IP Care > Oncology and Clinical Haematology
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Depositing User: Mrs Yolande Brookes
Date Deposited: 03 Jul 2014 13:45
Last Modified: 05 Jul 2014 10:35
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/288

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