Allogeneic haematopoietic stem cell transplantation (allo-HSCT) for these children has become a well-established treatment to control the disease. Despite remarkable improvement in the treatment of this malignancy, 20% of children still relapse, and their outcome remains poor. The data presented in this study provide valuable insight into the analysis of very early chimerism in children with ALL treated with HSCT.Ĭurrent chemotherapy regimens for acute lymphoblastic leukaemia (ALL) result in a remission in the majority of children with the disease. Acute graft versus host disease grades II-IV was diagnosed in 23 patients who presented with donor chimerism levels above 60% on day 7. The immunophenotypes of disease, age of patient at time HSCT, recipient sex, stem cell source (peripheral blood/bone marrow) and conditioning regimen had no impact on early chimerism. In our cohort of patients, the matched unrelated donor, male gender of donor, number of transplanted cells above 4.47 × 10 6 kg and no serotherapy with anti-thymocyte globulin (ATG) were statistically related to a higher level of donor chimerism. The OS in the group of 24 patients with complete donor chimerism on day + 14 was 83%, and it did not differ statistically compared to the 32 patients with mixed chimerism on day + 14 (OS was 84%). Overall survival (OS) and event-free survival (EFS) were 84 and 80%, respectively. Short tandem repeat polymerase chain reaction (STR PCR) was used to analyse chimerism. Very early chimerism was evaluated on days + 7, + 14, + 21 and + 28 after the transplant. The study group included 38 boys and 18 girls.
In this retrospective study, we evaluated the clinical impact of very early chimerism on the clinical outcome after allogeneic haematopoietic stem cell transplantation (allo-HSCT) in children with acute lymphoblastic leukaemia (ALL). The significance of very early chimerism assessment before day + 28, which is considered the moment of engraftment, is still unclear.
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