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Predicting Sickle Cell Disease Outcomes Post-HCT

Biol Blood Marrow Transplant; ePub 2017 Sep 4; Abraham, et al

Stable donor chimerism >25% following hematopoietic cell transplantation (HCT) for sickle cell disease (SCD) is linked with resolved SCD-related symptoms, according to a retrospective analysis involving 95 individuals. Meanwhile, hemoglobin S (HbS) level ≥50% predicts recurrent disease. Investigators looked at the link between chimerism, HbS level, and symptomatic disease in participants who underwent HCT and had chimerism reports from day 100, and 1 and 2 years after transplantation. Among the results:

  • 35 patients maintained full donor chimerism through 2 years.
  • Graft failure occurred in 13 patients during this period.
  • The remaining 47 patients had mixed chimerism ranging between 10% and 94%.
  • The lowest recorded donor chimerism without symptomatic disease was 26%.
  • Of 12 surviving patients with recurrent disease, 2 experienced recurrence prior to graft failure, with donor chimerism ranging between 11% and 17%.
  • 3 patients underwent second transplantation for graft failure; none received donor leukocyte infusion.

Citation:

Abraham A, Hsieh M, Eapen M, et alx. Relationship between mixed donor-recipient chimerism and disease recurrence following hematopoietic cell transplantation for sickle cell disease. [Published online ahead of print September 4, 2017]. Biol Blood Marrow Transplant. doi:10.1016/j.bbmt.2017.08.038.