Stable mixed hematopoietic chimerism after bone marrow transplantation for sickle cell anemia

M. C. Walters, M. Patience, W. Leisenring, Z. R. Rogers, V. M. Aquino, G. R. Buchanan, I. A G Roberts, Andrew M Yeager, L. Hsu, T. Adamkiewicz, J. Kurtzberg, E. Vichinsky, B. Storer, R. Storb, K. M. Sullivan

Research output: Contribution to journalArticle

205 Citations (Scopus)

Abstract

A multicenter investigation of allogeneic bone marrow transplantation for children with sickle cell disease was conducted that included 27 European and North American transplant centers. Fifty-nine patients who ranged in age from 3.3 to 15.9 years (median, 10.1 years) received HLA-identical sibling marrow allografts between September 1991 and April 2000. Fifty-five patients survive, and 50 survive free from sickle cell disease, with a median follow-up of 42.2 months (range, 11.8 to 115 months) after transplantation. Of the 50 patients with successful allografts, 13 developed stable mixed donor-host hematopoietic chimerism. The level of donor chimerism, measured ≥6 months after transplantation in peripheral blood, varied between 90% and 99% in 8 patients. Five additional patients had a lower proportion of donor cells (range, 11% to 74%). Among these 5 patients, hemoglobin levels varied between 11.2 and 14.2 g/dL (median, 11.3 g/dL; mean, 12.0 g/dL). In patients who had donors with a normal hemoglobin genotype (Hb), the Hb S fractions were 0%, 0%, and 7%, corresponding to donor chimerism levels of 67%, 74%, and 11%, respectively. Among patients who had donors with sickle trait, the Hb S fractions were 36% and 37%, corresponding to donor chimerism levels of 25% and 60%, respectively. Thus, allograft recipients with stable mixed chimerism had Hb S levels similar to donor levels, and only 1 patient required a red blood cell transfusion beyond 90 days posttransplantation. None of the patients have experienced painful events or other clinical complications related to sickle cell disease after transplantation. These observations strongly suggest that patients with sickle cell disease who develop persistent mixed hematopoietic chimerism after transplantation experience a significant ameliorative effect.

Original languageEnglish (US)
Pages (from-to)665-673
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume7
Issue number12
StatePublished - 2001
Externally publishedYes

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Chimerism
Sickle Cell Anemia
Bone Marrow Transplantation
Tissue Donors
Transplantation
Allografts
Hemoglobins
Erythrocyte Transfusion
Homologous Transplantation
Siblings
Bone Marrow
Genotype

Keywords

  • Bone marrow transplantation
  • Chimerism
  • Sickle cell anemia

ASJC Scopus subject areas

  • Transplantation

Cite this

Walters, M. C., Patience, M., Leisenring, W., Rogers, Z. R., Aquino, V. M., Buchanan, G. R., ... Sullivan, K. M. (2001). Stable mixed hematopoietic chimerism after bone marrow transplantation for sickle cell anemia. Biology of Blood and Marrow Transplantation, 7(12), 665-673.

Stable mixed hematopoietic chimerism after bone marrow transplantation for sickle cell anemia. / Walters, M. C.; Patience, M.; Leisenring, W.; Rogers, Z. R.; Aquino, V. M.; Buchanan, G. R.; Roberts, I. A G; Yeager, Andrew M; Hsu, L.; Adamkiewicz, T.; Kurtzberg, J.; Vichinsky, E.; Storer, B.; Storb, R.; Sullivan, K. M.

In: Biology of Blood and Marrow Transplantation, Vol. 7, No. 12, 2001, p. 665-673.

Research output: Contribution to journalArticle

Walters, MC, Patience, M, Leisenring, W, Rogers, ZR, Aquino, VM, Buchanan, GR, Roberts, IAG, Yeager, AM, Hsu, L, Adamkiewicz, T, Kurtzberg, J, Vichinsky, E, Storer, B, Storb, R & Sullivan, KM 2001, 'Stable mixed hematopoietic chimerism after bone marrow transplantation for sickle cell anemia', Biology of Blood and Marrow Transplantation, vol. 7, no. 12, pp. 665-673.
Walters MC, Patience M, Leisenring W, Rogers ZR, Aquino VM, Buchanan GR et al. Stable mixed hematopoietic chimerism after bone marrow transplantation for sickle cell anemia. Biology of Blood and Marrow Transplantation. 2001;7(12):665-673.
Walters, M. C. ; Patience, M. ; Leisenring, W. ; Rogers, Z. R. ; Aquino, V. M. ; Buchanan, G. R. ; Roberts, I. A G ; Yeager, Andrew M ; Hsu, L. ; Adamkiewicz, T. ; Kurtzberg, J. ; Vichinsky, E. ; Storer, B. ; Storb, R. ; Sullivan, K. M. / Stable mixed hematopoietic chimerism after bone marrow transplantation for sickle cell anemia. In: Biology of Blood and Marrow Transplantation. 2001 ; Vol. 7, No. 12. pp. 665-673.
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abstract = "A multicenter investigation of allogeneic bone marrow transplantation for children with sickle cell disease was conducted that included 27 European and North American transplant centers. Fifty-nine patients who ranged in age from 3.3 to 15.9 years (median, 10.1 years) received HLA-identical sibling marrow allografts between September 1991 and April 2000. Fifty-five patients survive, and 50 survive free from sickle cell disease, with a median follow-up of 42.2 months (range, 11.8 to 115 months) after transplantation. Of the 50 patients with successful allografts, 13 developed stable mixed donor-host hematopoietic chimerism. The level of donor chimerism, measured ≥6 months after transplantation in peripheral blood, varied between 90{\%} and 99{\%} in 8 patients. Five additional patients had a lower proportion of donor cells (range, 11{\%} to 74{\%}). Among these 5 patients, hemoglobin levels varied between 11.2 and 14.2 g/dL (median, 11.3 g/dL; mean, 12.0 g/dL). In patients who had donors with a normal hemoglobin genotype (Hb), the Hb S fractions were 0{\%}, 0{\%}, and 7{\%}, corresponding to donor chimerism levels of 67{\%}, 74{\%}, and 11{\%}, respectively. Among patients who had donors with sickle trait, the Hb S fractions were 36{\%} and 37{\%}, corresponding to donor chimerism levels of 25{\%} and 60{\%}, respectively. Thus, allograft recipients with stable mixed chimerism had Hb S levels similar to donor levels, and only 1 patient required a red blood cell transfusion beyond 90 days posttransplantation. None of the patients have experienced painful events or other clinical complications related to sickle cell disease after transplantation. These observations strongly suggest that patients with sickle cell disease who develop persistent mixed hematopoietic chimerism after transplantation experience a significant ameliorative effect.",
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