Treatment of Mixed Chimerism After Hematopoietic Stem Cell Transplantation in Patients with Thalassemia Major

Jianyun Liao; Shimin Liang; Jingtao Chen; Xiaoting Liu; Yuqian Xia; Jujian He; Weiwei Zhang; Chaoke Pu; Lan He; Yuelin He; Xiaoqin Feng; Xuedong Wu; Chunfu Li

doi:doi:10.11648/j.ajp.20241001.14

Research Article |

Treatment of Mixed Chimerism After Hematopoietic Stem Cell Transplantation in Patients with Thalassemia Major

Jianyun Liao^*, Shimin Liang, Jingtao Chen, Xiaoting Liu, Yuqian Xia, Jujian He, Weiwei Zhang, Chaoke Pu, Lan He, Yuelin He, Xiaoqin Feng, Xuedong Wu, Chunfu Li

Published in American Journal of Pediatrics (Volume 10, Issue 1)

Received: 4 January 2024 Accepted: 1 February 2024 Published: 20 February 2024

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Abstract

Background: Incomplete donor cell chimerism often occurs in thalassemia transplant due to host cells remain or reappear overtime, which is termed as mixed chimerism (MC). Objective: To compare the immunosuppression withdrawal (ISW) and donor lymphocyte infusion (DLI) in the correction of mixed chimerism (MC) after thalassemia transplantation. Methods: Eighty-seven patients with post-transplant MC admitted in our center from January 2010 to December 2019 were analyzed. Among them donor cells of 90%-95% and 75%-89% were classified as MC1 and MC2 respectively. MC3 donor cells <75%. The incidence and correction rate of MC, the occurrence rate of graft versus host disease (GVHD), timing of DLI were studied. Results: DLI was associated with higher correction rates and higher GVHD than ISW. In MC1 group, higher GVHD occurred in early and intermediate stage (P = 0.024/0.023) than ISW. In MC2 group, DLI in late stages had higher correction rates than ISW (P = 0.001). Conclusion: ISW was the primary strategy for MC1 patients. DLI should be given to the late-stage MC2 patients quickly. The earlier the treatment is provided, regardless of ISW or DLI, the more likely that patients develop GVHD.

Published in	American Journal of Pediatrics (Volume 10, Issue 1)
DOI	10.11648/j.ajp.20241001.14
Page(s)	18-25
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Mixed Chimerism, GVHD, Donor Lymphocyte Infusion, Thalassemia, HSCT

References

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APA Style

Liao, J., Liang, S., Chen, J., Liu, X., Xia, Y., et al. (2024). Treatment of Mixed Chimerism After Hematopoietic Stem Cell Transplantation in Patients with Thalassemia Major. American Journal of Pediatrics, 10(1), 18-25. https://doi.org/10.11648/j.ajp.20241001.14

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ACS Style

Liao, J.; Liang, S.; Chen, J.; Liu, X.; Xia, Y., et al. Treatment of Mixed Chimerism After Hematopoietic Stem Cell Transplantation in Patients with Thalassemia Major. Am. J. Pediatr. 2024, 10(1), 18-25. doi: 10.11648/j.ajp.20241001.14

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AMA Style

Liao J, Liang S, Chen J, Liu X, Xia Y, et al. Treatment of Mixed Chimerism After Hematopoietic Stem Cell Transplantation in Patients with Thalassemia Major. Am J Pediatr. 2024;10(1):18-25. doi: 10.11648/j.ajp.20241001.14

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@article{10.11648/j.ajp.20241001.14,
  author = {Jianyun Liao and Shimin Liang and Jingtao Chen and Xiaoting Liu and Yuqian Xia and Jujian He and Weiwei Zhang and Chaoke Pu and Lan He and Yuelin He and Xiaoqin Feng and Xuedong Wu and Chunfu Li},
  title = {Treatment of Mixed Chimerism After Hematopoietic Stem Cell Transplantation in Patients with Thalassemia Major},
  journal = {American Journal of Pediatrics},
  volume = {10},
  number = {1},
  pages = {18-25},
  doi = {10.11648/j.ajp.20241001.14},
  url = {https://doi.org/10.11648/j.ajp.20241001.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20241001.14},
  abstract = {Background: Incomplete donor cell chimerism often occurs in thalassemia transplant due to host cells remain or reappear overtime, which is termed as mixed chimerism (MC). Objective: To compare the immunosuppression withdrawal (ISW) and donor lymphocyte infusion (DLI) in the correction of mixed chimerism (MC) after thalassemia transplantation. Methods: Eighty-seven patients with post-transplant MC admitted in our center from January 2010 to December 2019 were analyzed. Among them donor cells of 90%-95% and 75%-89% were classified as MC1 and MC2 respectively. MC3 donor cells P = 0.024/0.023) than ISW. In MC2 group, DLI in late stages had higher correction rates than ISW (P = 0.001). Conclusion: ISW was the primary strategy for MC1 patients. DLI should be given to the late-stage MC2 patients quickly. The earlier the treatment is provided, regardless of ISW or DLI, the more likely that patients develop GVHD.
},
 year = {2024}
}

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TY  - JOUR
T1  - Treatment of Mixed Chimerism After Hematopoietic Stem Cell Transplantation in Patients with Thalassemia Major
AU  - Jianyun Liao
AU  - Shimin Liang
AU  - Jingtao Chen
AU  - Xiaoting Liu
AU  - Yuqian Xia
AU  - Jujian He
AU  - Weiwei Zhang
AU  - Chaoke Pu
AU  - Lan He
AU  - Yuelin He
AU  - Xiaoqin Feng
AU  - Xuedong Wu
AU  - Chunfu Li
Y1  - 2024/02/20
PY  - 2024
N1  - https://doi.org/10.11648/j.ajp.20241001.14
DO  - 10.11648/j.ajp.20241001.14
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 18
EP  - 25
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20241001.14
AB  - Background: Incomplete donor cell chimerism often occurs in thalassemia transplant due to host cells remain or reappear overtime, which is termed as mixed chimerism (MC). Objective: To compare the immunosuppression withdrawal (ISW) and donor lymphocyte infusion (DLI) in the correction of mixed chimerism (MC) after thalassemia transplantation. Methods: Eighty-seven patients with post-transplant MC admitted in our center from January 2010 to December 2019 were analyzed. Among them donor cells of 90%-95% and 75%-89% were classified as MC1 and MC2 respectively. MC3 donor cells P = 0.024/0.023) than ISW. In MC2 group, DLI in late stages had higher correction rates than ISW (P = 0.001). Conclusion: ISW was the primary strategy for MC1 patients. DLI should be given to the late-stage MC2 patients quickly. The earlier the treatment is provided, regardless of ISW or DLI, the more likely that patients develop GVHD.

VL  - 10
IS  - 1
ER  -

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Author Information

Jianyun Liao

Nanfang-Chunfu Children’s Institute of Hematology and Oncology, Taixin Hospital, Dongguan, China; Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China

Contact Email
Shimin Liang

Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
Jingtao Chen

Department of Pediatrics, Southwest Medical University, Luzhou, China
Xiaoting Liu

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Yuqian Xia

Nanfang-Chunfu Children’s Institute of Hematology and Oncology, Taixin Hospital, Dongguan, China
Jujian He

Nanfang-Chunfu Children’s Institute of Hematology and Oncology, Taixin Hospital, Dongguan, China
Weiwei Zhang

Nanfang-Chunfu Children’s Institute of Hematology and Oncology, Taixin Hospital, Dongguan, China
Chaoke Pu

Nanfang-Chunfu Children’s Institute of Hematology and Oncology, Taixin Hospital, Dongguan, China; Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Lan He

Nanfang-Chunfu Children’s Institute of Hematology and Oncology, Taixin Hospital, Dongguan, China; Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Yuelin He

Nanfang-Chunfu Children’s Institute of Hematology and Oncology, Taixin Hospital, Dongguan, China; Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Xiaoqin Feng

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Xuedong Wu

Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
Chunfu Li

Nanfang-Chunfu Children’s Institute of Hematology and Oncology, Taixin Hospital, Dongguan, China; Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China

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Plain Text BibTeX RIS

APA Style

Liao, J., Liang, S., Chen, J., Liu, X., Xia, Y., et al. (2024). Treatment of Mixed Chimerism After Hematopoietic Stem Cell Transplantation in Patients with Thalassemia Major. American Journal of Pediatrics, 10(1), 18-25. https://doi.org/10.11648/j.ajp.20241001.14

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ACS Style

Liao, J.; Liang, S.; Chen, J.; Liu, X.; Xia, Y., et al. Treatment of Mixed Chimerism After Hematopoietic Stem Cell Transplantation in Patients with Thalassemia Major. Am. J. Pediatr. 2024, 10(1), 18-25. doi: 10.11648/j.ajp.20241001.14

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AMA Style

Liao J, Liang S, Chen J, Liu X, Xia Y, et al. Treatment of Mixed Chimerism After Hematopoietic Stem Cell Transplantation in Patients with Thalassemia Major. Am J Pediatr. 2024;10(1):18-25. doi: 10.11648/j.ajp.20241001.14

Copy | Download

@article{10.11648/j.ajp.20241001.14,
  author = {Jianyun Liao and Shimin Liang and Jingtao Chen and Xiaoting Liu and Yuqian Xia and Jujian He and Weiwei Zhang and Chaoke Pu and Lan He and Yuelin He and Xiaoqin Feng and Xuedong Wu and Chunfu Li},
  title = {Treatment of Mixed Chimerism After Hematopoietic Stem Cell Transplantation in Patients with Thalassemia Major},
  journal = {American Journal of Pediatrics},
  volume = {10},
  number = {1},
  pages = {18-25},
  doi = {10.11648/j.ajp.20241001.14},
  url = {https://doi.org/10.11648/j.ajp.20241001.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20241001.14},
  abstract = {Background: Incomplete donor cell chimerism often occurs in thalassemia transplant due to host cells remain or reappear overtime, which is termed as mixed chimerism (MC). Objective: To compare the immunosuppression withdrawal (ISW) and donor lymphocyte infusion (DLI) in the correction of mixed chimerism (MC) after thalassemia transplantation. Methods: Eighty-seven patients with post-transplant MC admitted in our center from January 2010 to December 2019 were analyzed. Among them donor cells of 90%-95% and 75%-89% were classified as MC1 and MC2 respectively. MC3 donor cells P = 0.024/0.023) than ISW. In MC2 group, DLI in late stages had higher correction rates than ISW (P = 0.001). Conclusion: ISW was the primary strategy for MC1 patients. DLI should be given to the late-stage MC2 patients quickly. The earlier the treatment is provided, regardless of ISW or DLI, the more likely that patients develop GVHD.
},
 year = {2024}
}

Copy | Download

TY  - JOUR
T1  - Treatment of Mixed Chimerism After Hematopoietic Stem Cell Transplantation in Patients with Thalassemia Major
AU  - Jianyun Liao
AU  - Shimin Liang
AU  - Jingtao Chen
AU  - Xiaoting Liu
AU  - Yuqian Xia
AU  - Jujian He
AU  - Weiwei Zhang
AU  - Chaoke Pu
AU  - Lan He
AU  - Yuelin He
AU  - Xiaoqin Feng
AU  - Xuedong Wu
AU  - Chunfu Li
Y1  - 2024/02/20
PY  - 2024
N1  - https://doi.org/10.11648/j.ajp.20241001.14
DO  - 10.11648/j.ajp.20241001.14
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 18
EP  - 25
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20241001.14
AB  - Background: Incomplete donor cell chimerism often occurs in thalassemia transplant due to host cells remain or reappear overtime, which is termed as mixed chimerism (MC). Objective: To compare the immunosuppression withdrawal (ISW) and donor lymphocyte infusion (DLI) in the correction of mixed chimerism (MC) after thalassemia transplantation. Methods: Eighty-seven patients with post-transplant MC admitted in our center from January 2010 to December 2019 were analyzed. Among them donor cells of 90%-95% and 75%-89% were classified as MC1 and MC2 respectively. MC3 donor cells P = 0.024/0.023) than ISW. In MC2 group, DLI in late stages had higher correction rates than ISW (P = 0.001). Conclusion: ISW was the primary strategy for MC1 patients. DLI should be given to the late-stage MC2 patients quickly. The earlier the treatment is provided, regardless of ISW or DLI, the more likely that patients develop GVHD.

VL  - 10
IS  - 1
ER  -

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