Abstract
Background. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a definitive therapy for patients with different oncological and hematological diseases. The study of red cell chimerism is a crucial process for diagnosing transplant engraftment and functioning during the post-transplantation period.
Aim. To assess the effect of immunohematological (АВО and HLA donor–recipient matching) and medical (conditioning regimens) parameters on the onset time of post-transplantation donor chimerism which is determined by RBC antigens.
Materials & Methods. The study enrolled 54 patients at the Kirov Research Institute of Hematology and Transfusiology in Russia (25 female and 29 male patients) aged 3–60 years (median 32 years). All of them received allo-HSCT in 2013–2021. Acute leukemias were identified in 39 patients, 8 patients were reported to have malignant lymphoproliferative diseases, 3 patients had myeloproliferative neoplasms, and 4 patients were diagnosed with aplastic anemia. RBC antigens of donors and recipients were analyzed by gel hemagglutination using Bio-Rad (USA) reagents and equipment.
Results. The onset time of donor chimerism depends neither on the degree of HLA donor–recipient matching, nor on conditioning regimen. Donor chimerism in recipients with major ABO-incompatibility occurs significantly later than in patients with minor АВО-incompatibility and ABO-identity.
Conclusion. Monitoring of post-transplantation donor chimerism is an important diagnostic and prognostic tool to assess donor hematopoietic cell engraftment, hematologic recovery, graft rejection, and relapse of the disease. After allo-HSCT, first donor red cells occur in pairs with major АВО-incompatibility later than in pairs with minor АВО-incompatibility or ABO antigen compatibility. Other immunohematological and medical parameters do not affect the development rate of donor chimerism determined by RBC antigens.
References
- Лавриненко В.А., Савицкая Т.В., Волочник Е.В. и др. Количественный анализ химеризма после аллогенной трансплантации гемопоэтических стволовых клеток молекулярно-генетическими методами. Онкогематология. 2014;9(2):29–36.
- [Lavrinenko VA, Savitskaya TV, Volochnik EV, et al. Quantitative analysis of chimerism after allogeneic hematopoietic stem cell transplantation with molecular genetic methods. 2014;9(2):29–36. (In Russ)]
- Vaezi M, Dameshghi DO, Souri M, et al. ABO Incompatibility and Hematopoietic Stem Cell Transplantation Outcomes. Int J Hematol Oncol Stem Cell Res. 2017;11(2):139–47.
- Лавриненко В.А., Марейко Ю.Е., Березовская Е.Ю. и др. Становление донорского химеризма у пациентов с первичными иммунодефицитами после аллогенной трансплантации гемопоэтических стволовых клеток. Онкогематология. 2018;13(2):82–92. doi: 10.17650/1818-8346-2018-13-2-82-92.
- [Lavrinenko VA, Marejco YE, Berezovskaya EY, et al. Donor chimerism in patients with primary immunodeficiency after allogeneic hematopoietic stem cell transplantation. Oncohematology. 2018;13(2):82–92. doi: 10.17650/1818-8346-2018-13-2-82-92. (In Russ)]
- Богданов К.В., Моторин Д.В., Никулина Т.С. и др. Мониторинг донорского химеризма и минимальной остаточной болезни у онкогематологических больных после аллогенной трансплантации гемопоэтических стволовых клеток. Биомедицинская химия. 2017;63(6):570–81. doi: 18097/PBMC20176306570.
- [Bogdanov KV, Motorin DV, Nikulina TS, et al. Donor chimerism and minimal residual disease monitoring in leukemia patients after allo-HSCT. Biomeditsinskaya khimiya. 2017;63(6):570–81. doi: 10.18097/PBMC20176306570. (In Russ)]
- Минаковская Н.В., Марейко Ю.Е., Кирсанова Н.П. и др. Трансплантации гемопоэтических стволовых клеток у детей и молодых взрослых в Республике Беларусь. Гематология. Трансфузиология. Восточная Европа. 2017;3(3):271–84.
- [Minakovskaya NV, Mareiko YuE, Kirsanova NP, et al. Hematopoietic stem cell transplantation in children and young adults in the Republic of Belarus. Gematologiya. Transfuziologiya. Vostochnaya Evropa. 2017;3(3):271–84. (In Russ)]
- Worel N. ABО-mismatched allogeneic hematopoietic stem cell transplantation. Transfus Med Hemother. 2016;43(1):3–12. doi: 10.1159/000441507
- Лавриненко В.А., Марейко Ю.Е., Красько О.В. и др. Химеризм и восстановление гемопоэза после аллогенной трансплантации гемопоэтических стволовых клеток при апластических анемиях у детей. Гематология. Трансфузиология. Восточная Европа. 2016;2(4):206–7.
- [Lavrinenko VA, Mareiko YuE, Krasko OV, et al. Chimerism and hematopoietic reconstitution after allogeneic stem cell transplantation in children with aplastic anemia. Gematologiya. Transfuziologiya. Vostochnaya Evropa. 2016;2(4):206–7. (In Russ)]
- Rydberg L. ABO-incompatibility in solid organ transplantation. Transfus Med. 2001;11(4):325–42. doi: 10.1046/j.1365-3148.2001.00313.x.
- Кучер M.A., Певцов Д.Э., Макаренко О.А. и др. АВ0-несовместимость при аллогенной трансплантации гемопоэтических клеток: анализ 15-летнего опыта НИИ детской онкологии, гематологии и трансплантологии имени Р.М. Горбачевой. Онкогематология. 2016;11(4):49–55. doi: 10.17650/1818-8346-2016-11-4-49-55.
- [Kucher MA, Pevtcov DE, Makarenko OA, et al. АВ0-incompatibility in allogeneic hematopoietic stem cell transplantation: 15-years experience of R.M. Gorbacheva Memorial Research Institute for Children Oncology, Hematology and Transplantation. Oncohematology. 2016;11(4):49–55. doi: 10.17650/1818-8346-2016-11-4-49-55. (In Russ)]
- Хамаганова Е.Г., Кузьмина Л.А. Оценка HLA-совместимости и требования к HLA-типированию больного и донора при трансплантации аллогенных гемопоэтических стволовых клеток. Гематология и трансфузиология. 2019;64(2):175–87. doi: 10.35754/0234-5730-2019-64-2-175-187.
- [Khamaganova EG, Kuzmina LA. Assessment of HLA-compatibility and requirements for HLA-typing of patient and donor in allogeneic hematopoietic stem cell transplantation. Russian journal of hematology and transfusiology. 2019;64(2):175–87. doi: 10.35754/0234-5730-2019-64-2-175-187. (In Russ)]
- Bolan CD, Leitman SF, Griffith LM, et al. Delayed donor red cell chimerism and pure red cell aplasia following major ABO-incompatible nonmyeloablative hematopoietic stem cell transplantation. 2001;98(6):1687–94. doi: 10.1182/blood.V98.6.1687.
- Wang Z, Sorror ML, Leisenring W. The Impact of Donor Type and ABO Incompatibility on Transfusion Requirements after Nonmyeloablative Hematopoietic Cell Transplantation (HCT). Br J Haematol. 2010;149(1):101–10. doi: 10.1016/j.bbmt.2009.12.323.
- Йовдий А.В., Бутина Е.В., Попонина Е.А. и др. Интерпретация результатов иммуногематологических исследований у пациентов гематологической клиники. Клиническая лабораторная диагностика. 2019;64(4):221–4. doi: 18821/0869-2084-2019-64-4-221-224.
- [Yovdiy AV, Butina EV, Poponina EA, et al. Interpretation of the results of immunohematological tests in hematological patients. Klinicheskaya laboratornaya diagnostika. 2019;64(4):221–4. doi: 10.18821/0869-2084-2019-64-4-221-224. (In Russ)]
- Бутина Е.В., Минеева Н.В., Зайцева Г.А. и др. Аллоиммунизация к антигенам эритроцитов у пациентов с гематологическими и онкогематологическими заболеваниями. Трансфузиология. 2019;21(2):27–34.
- [Butina EV, Mineeva NV, Zaitseva GA, et al. Red blood cell alloimmunization in patients with hematology/oncology disorders. Transfuziologiya. 2019;21(2):27–34. (In Russ)]
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright (c) 2023 Clinical Oncohematology