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Early mixed T‐cell chimerism is predictive of pediatric AML or MDS relapse after hematopoietic stem cell transplant |
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| Authors: | Larisa Broglie Irene Helenowski Lawrence J. Jennings Kristian Schafernak Reggie Duerst Jennifer Schneiderman William Tse Morris Kletzel Sonali Chaudhury |
| Affiliation: | 1. Division of Blood and Marrow Transplantation, Department of Pediatrics, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin;2. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois;3. Department of Pathology and Laboratory Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois;4. Department of Pathology, Phoenix Children's Hospital, Phoenix, Arizona;5. 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 |
| 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. |
| Keywords: | AML chimerism HCT pediatrics relapse |