Molecular monitoring of T-cell chimerism early after allogeneic stem cell transplantation may predict the occurrence of acute GVHD grades II-IV.
Mixed chimerism (MC) within CD4+ and CD8+ T cell days 7 and 10 after allogeneic stem cell transplantation (SCT) was compared with the occurrence of acute graft-vs.-host disease (GVHD) in 34 patients after SCT. Acute GVHD was diagnosed in 22 patients within the first 3 months after SCT, 15 of these developed acute GVHD grades II-IV. The difference in the clearance rate of host T cell between the two days were compared. We found a significantly higher risk (p = 0.005) for developing acute GVHD grades II-IV in patients with complete donor CD4+ T-cell chimerism day 7 after SCT together with patients who increased 50% or more in donor CD4+ T cells between days 7 and 10 after SCT. Our data suggest that molecular monitoring of MC early after transplantation may be useful as a diagnostic tool in predicting the occurrence of moderate to severe acute GVHD after SCT.
Jaksch
Marie
M
Division of Clinical Immunology, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden. marie.jaksch@labmed.ki.se
Uzunel
Mehmet
M
Remberger
Mats
M
Sundberg
Berit
B
Mattsson
Jonas
J
D000293:Adolescent; D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D046528:Chimerism; D005260:Female; D006086:Graft vs Host Disease / Q000235:genetics* / Q000276:immunology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D014184:Transplantation, Homologous