title: Early mixed T-cell chimerism is predictive of pediatric AML or MDS relapse after hematopoietic stem cell transplant.
abstract: Patients with acute myeloid leukemia (AML) who relapse after hematopoietic stem cell transplantation (HCT) have dismal outcomes. Our ability to predict those at risk for relapse is limited. We examined chimerism trends post-HCT in 63 children who underwent HCT for AML or myelodysplastic syndrome (MDS). Mixed T-cell chimerism at engraftment and absence of chronic graft versus host disease (cGVHD) were associated with relapse (P = 0.04 and P = 0.02, respectively). Mixed T-cell chimerism at engraftment was predictive in patients without cGVHD (P = 0.03). Patients with engraftment mixed T-cell chimerism may warrant closer disease monitoring and consideration for early intervention.
authors.affiliation: Division of Blood and Marrow Transplantation, Department of Pediatrics, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Larisa
authors.initials: L
authors.lastname: Broglie
authors.affiliation: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Irene
authors.initials: I
authors.lastname: Helenowski
authors.affiliation: Department of Pathology and Laboratory Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Jennings
authors.affiliation: Department of Pathology, Phoenix Children's Hospital, Phoenix, Arizona.
authors.forename: Kristian
authors.initials: K
authors.lastname: Schafernak
authors.affiliation: Division of Hematology, Oncology and Stem Cell Transplant, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Reggie
authors.initials: R
authors.lastname: Duerst
authors.affiliation: Division of Hematology, Oncology and Stem Cell Transplant, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Schneiderman
authors.affiliation: Division of Hematology, Oncology and Stem Cell Transplant, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: William
authors.initials: W
authors.lastname: Tse
authors.affiliation: Division of Hematology, Oncology and Stem Cell Transplant, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Morris
authors.initials: M
authors.lastname: Kletzel
authors.affiliation: Division of Hematology, Oncology and Stem Cell Transplant, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Sonali
authors.initials: S
authors.lastname: Chaudhury
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D046528:Chimerism; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000276:immunology* / Q000628:therapy*; D008297:Male; D009190:Myelodysplastic Syndromes / Q000276:immunology* / Q000628:therapy*; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000276:immunology*; D018183:Transplantation Chimera; D055815:Young Adult
keywords: AML; HCT; chimerism; pediatrics; relapse