Cord blood maternal microchimerism following unrelated cord blood transplantation

SB Kanaan, C Delaney, F Milano… - Bone marrow …, 2021 - nature.com
SB Kanaan, C Delaney, F Milano, A Scaradavou, K Besien, J Allen, NC Lambert, E Cousin…
Bone marrow transplantation, 2021nature.com
Cord blood transplantation (CBT) is associated with low risk of leukemia relapse.
Mechanisms underlying antileukemia benefit of CBT are not well understood, however a
previous study strongly but indirectly implicated cells from the mother of the cord blood (CB)
donor. A fetus acquires a small number of maternal cells referred to as maternal
microchimerism (MMc) and MMc is sometimes detectable in CB. From a series of 95 patients
who underwent double or single CBT at our center, we obtained or generated HLA …
Abstract
Cord blood transplantation (CBT) is associated with low risk of leukemia relapse. Mechanisms underlying antileukemia benefit of CBT are not well understood, however a previous study strongly but indirectly implicated cells from the mother of the cord blood (CB) donor. A fetus acquires a small number of maternal cells referred to as maternal microchimerism (MMc) and MMc is sometimes detectable in CB. From a series of 95 patients who underwent double or single CBT at our center, we obtained or generated HLA-genotyping of CB mothers in 68. We employed a technique of highly sensitive HLA-specific quantitative-PCR assays targeting polymorphisms unique to the CB mother to assay CB-MMc in patients post-CBT. After additional exclusion criteria, CB-MMc was evaluated at multiple timepoints in 36 patients (529 specimens). CB-MMc was present in seven (19.4%) patients in bone marrow, peripheral blood, innate and adaptive immune cell subsets, and was detected up to 1-year post-CBT. Statistical trends to lower relapse, mortality, and treatment failure were observed for patients with vs. without CB-MMc post-CBT. Our study provides proof-of-concept that maternal cells of the CB graft can be tracked in recipients post-CBT, and underscore the importance of further investigating CB-MMc in sustained remission from leukemia following CBT.
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