CHIMERISM AS A PROGNOSTIC FACTOR OF RELAPSE AFTER ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION IN HEMATOLOGICAL MALIGNANCIES

Relapse remains one of the main causes of treatment failure and mortality after allogeneic hematopoietic stem cell transplantation (alloHSCT) in patients with hematological malignancies. Chimerism monitoring provides information on engraftment and risk of relapse. The results of 104 alloHSCT performed in patients with hematological malignancies during 2009–2016 were included. Increasing mixed chimerism (MC) was an unfavorable prognostic factor for the event-free survival (EFS) (HR = 6.9, p < 0.0001) and was associated with a high risk of relapse after alloHSCT (HR = 12.2, p < 0.0001). EFS in patients with full donor chimerism (FDC), decreasing MC, increasing MC was 68.1 ± 6.4; 60.0 ± 21.9 and 0 % (p < 0.0001), the cumulative incidence of relapse was 10.8 ± 4.6; 0 and 81.3 ± 10.8 % (p < 0.0001), respectively. Increasing MC was detected in 2–435 (median 23.5) days before relapse in 10 (62.5 %) of 16 cases. Increasing MC appeared in bone marrow earlier and more often than in peripheral blood (p = 0.06). During hematologic relapse, FDC in peripheral blood can be observed. A graft-versushost disease was observed more often in patients with full donor chimerism than with MC (p = 0.0004).

chimerism, allogeneic hematopoietic stem cell transplantation, relapse, graft-versus-host disease, prognosis, children

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