PMID- 32618429 OWN - NLM STAT- MEDLINE DCOM- 20201207 LR - 20210715 IS - 1545-5017 (Electronic) IS - 1545-5009 (Linking) VI - 67 IP - 9 DP - 2020 Sep TI - Risk factors for mixed chimerism in children with hemophagocytic lymphohistiocytosis after reduced toxicity conditioning. PG - e28523 LID - 10.1002/pbc.28523 [doi] AB - BACKGROUND: Reduced toxicity conditioning for hematopoietic stem cell transplantation of patients with hemophagocyticlymphohistiocytosis (HLH) results in favorable survival, however at the expense of relevant rates of mixed chimerism. Factors predisposing to mixed chimerism remain to be determined. PROCEDURE: Patients with primary HLH transplanted 2009-2016 after treosulfan- or melphalan-based conditioning regimens were analyzed in a retrospective multicenter study for survival, engraftment, chimerism, and adverse events. Mixed chimerism was considered substantial if < 25% donor chimerism occurred and/or if secondary cell therapy was administered. Donor type, graft source, type of alkylating agent, type of serotherapy, and remission status were analyzed as potential risk factors in a multivariable logistic regression model. RESULTS: Among 60 patients, engraftment was achieved in 95%, and the five-year estimated overall survival rate was 75%. Prevalence of any recipient chimerism was 48%. Substantial recipient chimerism was recorded in 32% of patients. Secondary post-HSCT cell therapy was administered in 30% of patients. A human leukocyte antigen (HLA)-mismatched donor (< 10/10) was the only significant risk factor for the occurrence of substantial recipient chimerism (P = 0.01; odds ratio, 5.8; CI 95%, 1.5-26.3). CONCLUSION: The use of an HLA-matched donor is the most important factor to avoid substantial recipient chimerism following treosulfan -or melphalan-based conditioning in primary HLH. CI - (c) 2020 Wiley Periodicals LLC. FAU - Wustrau, Katharina AU - Wustrau K AUID- ORCID: 0000-0003-0400-8563 AD - Division of Pediatric Stem Cell Transplantation and Immunology, University Medical Center Hamburg, Hamburg, Germany. FAU - Greil, Johann AU - Greil J AD - Pediatric Hematology and Oncology, University Hospital Heidelberg, Heidelberg, Germany. FAU - Sykora, Karl-Walter AU - Sykora KW AD - Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany. FAU - Albert, Michael H AU - Albert MH AD - Pediatric Hematology and Oncology, Dr. von Hauner University Children's Hospital, Munich, Germany. FAU - Burkhardt, Birgit AU - Burkhardt B AD - Pediatric Hematology and Oncology, University Hospital Munster, Munster, Germany. FAU - Lang, Peter AU - Lang P AD - Pediatric Hematology and Oncology, University Hospital Tubingen, Tubingen, Germany. FAU - Meisel, Roland AU - Meisel R AD - Division of Pediatric Stem Cell Therapy, Clinic for Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Heinrich-Heine-University, Dusseldorf, Germany. FAU - Wossmann, Wilhelm AU - Wossmann W AD - Pediatric Hematology and Oncology, University Hospital Giessen, Giessen, Germany. FAU - Beier, Rita AU - Beier R AD - Pediatric Hematology and Oncology, University Hospital Essen, Essen, Germany. FAU - Schulz, Ansgar AU - Schulz A AD - Department of Pediatrics, University Medical Center Ulm, Ulm, Germany. FAU - Bader, Peter AU - Bader P AD - Division for Stem Cell Transplantation and Immunology, University Hospital for Children and Adolescent Medicine, Frankfurt am Main, Germany. FAU - Chada, Martin AU - Chada M AD - Pediatric Hematology and Oncology, University Hospital Erlangen, Erlangen, Germany. FAU - Kuhl, Jorn-Sven AU - Kuhl JS AD - Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany. FAU - Schlegel, Paul-Gerhardt AU - Schlegel PG AD - Pediatric Oncology, Hematology and Stem Cell Transplantation, University Children's Hospital, University of Wurzburg, Wurzburg, Germany. FAU - Speckmann, Carsten AU - Speckmann C AD - Center of Chronic Immunodeficiency, Faculty of Medicine, Institute for Immunodeficiency, University Medical Center, University of Freiburg, University of Freiburg, Freiburg, Germany. AD - Center for Pediatrics and Adolescent Medicine, Faculty of Medicine, University Medical Center, University of Freiburg, University of Freiburg, Freiburg, Germany. FAU - Gruhn, Bernd AU - Gruhn B AD - Department of Pediatrics, Jena University Hospital, Jena, Germany. FAU - Seidel, Markus AU - Seidel M AUID- ORCID: 0000-0003-0981-8661 AD - Division of Pediatric-Hemato-Oncology, Department of Pediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria. FAU - Wawer, Angela AU - Wawer A AD - Pediatric Hematology and Oncology, University Hospital Munich, Munich, Germany. FAU - Ozga, Ann-Kathrin AU - Ozga AK AD - Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg, Hamburg, Germany. FAU - Janka, Gritta AU - Janka G AD - Department of Pediatric Hematology and Oncology, University Medical Center Hamburg, Hamburg, Germany. FAU - Ehl, Stephan AU - Ehl S AD - Center of Chronic Immunodeficiency, Faculty of Medicine, Institute for Immunodeficiency, University Medical Center, University of Freiburg, University of Freiburg, Freiburg, Germany. AD - Center for Pediatrics and Adolescent Medicine, Faculty of Medicine, University Medical Center, University of Freiburg, University of Freiburg, Freiburg, Germany. FAU - Muller, Ingo AU - Muller I AUID- ORCID: 0000-0002-7477-6632 AD - Division of Pediatric Stem Cell Transplantation and Immunology, University Medical Center Hamburg, Hamburg, Germany. FAU - Lehmberg, Kai AU - Lehmberg K AD - Division of Pediatric Stem Cell Transplantation and Immunology, University Medical Center Hamburg, Hamburg, Germany. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20200703 PL - United States TA - Pediatr Blood Cancer JT - Pediatric blood & cancer JID - 101186624 RN - 0 (HLA Antigens) RN - CO61ER3EPI (treosulfan) RN - G1LN9045DK (Busulfan) RN - Q41OR9510P (Melphalan) SB - IM CIN - Pediatr Blood Cancer. 2021 Mar;68(3):e28602. PMID: 32893946 MH - Adolescent MH - Antineoplastic Combined Chemotherapy Protocols/*adverse effects MH - Busulfan/administration & dosage/analogs & derivatives MH - Child MH - Child, Preschool MH - Chimerism/*chemically induced MH - Female MH - Follow-Up Studies MH - Graft vs Host Disease/*etiology/pathology MH - HLA Antigens/immunology MH - Hematopoietic Stem Cell Transplantation/methods MH - Humans MH - Infant MH - Lymphohistiocytosis, Hemophagocytic/*drug therapy/pathology/therapy MH - Male MH - Melphalan/administration & dosage MH - Prognosis MH - Retrospective Studies MH - Risk Factors MH - Survival Rate MH - Tissue Donors MH - Transplantation Conditioning/*adverse effects MH - Transplantation, Homologous OTO - NOTNLM OT - chimerism OT - hemophagocyticlymphohistiocytosis OT - melphalan OT - toxicity OT - treosulfan EDAT- 2020/07/04 06:00 MHDA- 2020/12/15 06:00 CRDT- 2020/07/04 06:00 PHST- 2020/03/17 00:00 [received] PHST- 2020/06/03 00:00 [revised] PHST- 2020/06/05 00:00 [accepted] PHST- 2020/07/04 06:00 [pubmed] PHST- 2020/12/15 06:00 [medline] PHST- 2020/07/04 06:00 [entrez] AID - 10.1002/pbc.28523 [doi] PST - ppublish SO - Pediatr Blood Cancer. 2020 Sep;67(9):e28523. doi: 10.1002/pbc.28523. Epub 2020 Jul 3.