Comparison of Total Leukocyte Chimerism and Lymphocyte Subset Chimerism for Early Detection of Post-Transplant Complications

IF 1.6 4区医学 Q4 IMMUNOLOGY

Transplant immunology Pub Date : 2026-04-01 Epub Date: 2026-02-09 DOI:10.1016/j.trim.2026.102361

Metban Mastanzade , Figen Abatay Sel , İpek Yönal Hindilerden , Yeliz Duvarcı Öğret , Meliha Nalçacı , Fatma Savran Oğuz , Sevgi Kalayoğlu Beşışık

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引用次数: 0

Abstract

Purpose

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is associated with risks of GVHD, graft rejection, and relapse. Chimerism monitoring supports early detection, though the prognostic value of B- and T-cell chimerism remains unclear. We aimed to compare total leukocyte chimerism with lymphocyte subset chimerism to determine their clinical utility in predicting relapse, GVHD, and overall survival (OS) in allo-HSCT recipients.

Methods

Patients with hematologic malignancies who underwent allo-HSCT from an HLA-matched sibling or unrelated donor were included. Total leukocyte, B-cell, and T-cell chimerism were analyzed on days 28 and 90 post-transplant. DNA was isolated using a DTAB/CTAB-based method, and chimerism was determined via STR-PCR and capillary electrophoresis. Associations with relapse, GVHD, and event-free survival (EFS) were evaluated. Statistical analysis was performed using SPSS v21.0, including Fisher's exact test, Mann-Whitney U test, and Kaplan-Meier survival analysis.

Results

Among 21 allo-HSCT recipients, full donor chimerism (FDC) was observed in 95.2% and mixed chimerism (MC) in 4.8%. Most patients with acute (52.4%) and chronic GVHD (47.6%), relapse (4.8%), or death (19.0%) had FDC. These patterns were consistent across B, T, and total leukocyte subsets on days 28 and 90. Mean disease-free survival was 8.7 months; OS was 11.3 months. No statistically significant association was found between chimerism type and relapse, GVHD, or survival. EFS also did not differ between FDC and MC.

Conclusions

Lineage-specific chimerism analysis may enhance early detection of post-transplant complications and improve monitoring precision. However, its clinical utility requires validation in larger cohorts.

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白细胞总嵌合与淋巴细胞亚群嵌合在移植后并发症早期检测中的比较。

目的：同种异体造血干细胞移植（allo-HSCT）与GVHD、移植物排斥反应和复发的风险相关。嵌合监测支持早期发现，尽管B细胞和t细胞嵌合的预后价值尚不清楚。我们的目的是比较总白细胞嵌合和淋巴细胞亚群嵌合，以确定它们在预测同种异体移植受体复发、GVHD和总生存期（OS）方面的临床应用。方法：血液恶性肿瘤患者接受同种异体造血干细胞移植来自hla匹配的兄弟姐妹或非亲属供体。在移植后28天和90天分析白细胞、b细胞和t细胞的嵌合情况。采用基于DTAB/ ctab的方法分离DNA，通过STR-PCR和毛细管电泳检测嵌合性。评估与复发、GVHD和无事件生存期（EFS）的关系。采用SPSS v21.0进行统计学分析，包括Fisher精确检验、Mann-Whitney U检验和Kaplan-Meier生存分析。结果：21例同种异体造血移植受者中，完全供体嵌合（FDC）占95.2%，混合嵌合（MC）占4.8%。大多数急性（52.4%）和慢性GVHD（47.6%）、复发（4.8%）或死亡（19.0%）患者有FDC。这些模式在第28天和第90天的B、T和总白细胞亚群中是一致的。平均无病生存期为38.7 个月；OS为11.3 months。嵌合类型与复发、GVHD或生存率之间没有统计学上的显著关联。结论：谱系特异性嵌合分析可提高移植后并发症的早期发现，提高监测精度。然而，其临床应用需要在更大的队列中进行验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplant immunology 医学-免疫学

CiteScore

2.10

自引率

13.30%

发文量

198

审稿时长

48 days

期刊介绍： Transplant Immunology will publish up-to-date information on all aspects of the broad field it encompasses. The journal will be directed at (basic) scientists, tissue typers, transplant physicians and surgeons, and research and data on all immunological aspects of organ-, tissue- and (haematopoietic) stem cell transplantation are of potential interest to the readers of Transplant Immunology. Original papers, Review articles and Hypotheses will be considered for publication and submitted manuscripts will be rapidly peer-reviewed and published. They will be judged on the basis of scientific merit, originality, timeliness and quality.