title: Achievement of early complete donor chimerism in CD25+-activated leukocytes is a strong predictor of the development of graft-versus-host-disease after stem cell transplantation.
abstract: Chimerism dynamics in bone marrow, peripheral blood (PB), and T lymphocytes (TL) has been associated with the development of various complications after allogeneic stem-cell transplantation (allo-SCT). In the present study, the usefulness of chimerism monitoring in CD25(+)-activated leukocytes (AL), together with that in bone marrow, PB, and TL, for the anticipation of complications after allo-SCT, has been analyzed in 68 patients. In AL, we observed a slower dynamics toward complete chimerism (CC) than in PB (p = 0.042), while no significant differences were found between TL and PB (p = 0.12). Complete chimerism achievement in AL at day +30 has shown to be an independent risk factor for the development of grade II-IV acute graft-versus-host disease (aGvHD; hazard ratio [95% confidence interval]: 11.9 [1.5-91.7]; p = 0.017). Moreover, among patients achieving CC in TL and AL at different time-points after SCT (n = 17/68), the incidence of grade II-IV aGvHD was significantly higher in patients who achieved CC earlier in AL (5/5) than in those who achieved CC earlier in TL (1/11; p = 0.001). Therefore, achievement of early complete donor chimerism in CD25(+) AL is a strong predictor for the development of aGvHD. Prospective analysis of chimerism in AL could improve the post-SCT management of immunosuppressive therapy in transplanted patients.
authors.affiliation: Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: Carolina
authors.initials: C
authors.lastname: Martínez-Laperche
authors.affiliation: Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: Noriega
authors.affiliation: Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: Mi
authors.initials: M
authors.lastname: Kwon
authors.affiliation: Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: Pascual
authors.initials: P
authors.lastname: Balsalobre
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Sequencing and Genotyping Research Support Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Milagros
authors.initials: M
authors.lastname: González-Rivera
authors.affiliation: Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Serrano
authors.affiliation: Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Anguita
authors.affiliation: Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Gayoso
authors.affiliation: Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Díez-Martín
authors.affiliation: Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain. Electronic address: ismaelbuno@gmail.com.
authors.forename: Ismael
authors.initials: I
authors.lastname: Buño
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts; D019070:Cell Lineage; D046528:Chimerism; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000097:blood* / Q000209:etiology; D006402:Hematologic Diseases / Q000628:therapy; D006801:Humans; D053645:Interleukin-2 Receptor alpha Subunit / Q000032:analysis; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D016019:Survival Analysis; D018183:Transplantation Chimera; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D053645:Interleukin-2 Receptor alpha Subunit