Atopy: Weighing Risk With the Possibility of Cure Using Hematopoietic Cell Transplantation – Hematology Advisor

By daniellenierenberg

Contraryto previous research, some patients with atopy who undergo allogeneichematopoietic cell transplantation (AHCT) may be cured even if the donor isatopic, according to research published in Bone Marrow Transplantation.

Investigatorsaimed to determine whether atopic disease could be cured or transferred fromdonor to recipient, as there is evidence, though unconfirmed, that AHCT caneither transfer atopy from donor to recipient when the donor has the conditionand the recipient does not (D+R-), or cure atopy in a recipient with thecondition when the donor does not have it (D-R+).

Of the 54 participants including in the study, the median age at transplant was 46 years (range, 4-64 years), one-third of patients had acute myeloid leukemia, and 50% had a human leukocyte antigenmatched sibling. The median donor age at transplant was 34 years (range, 7-60 years).

Amongall AHCT procedures included in this study, 18 (33%) had an atopic donor andrecipient (D+R+), 13 (24%) had a nonatopic donor and recipient (D-R-), 11(20.4%) had an atopic donor and nonatopic recipient, and 12 (22.2%) had anonatopic donor and an atopic recipient.

At afollow-up of at least 2-years post-HCT, 7 of 12 (58%) D-R+ patients becamenonatopic, while only 1 of 11 (9%) D+R- patients became atopic. While 11 of 13(85%) D-R- patients remained nonatopic, 11 of 18 (61%) D+R+ patients became nonatopic,as well.

Inconclusion, cure of atopy with HCT occurs in about half patients, albeitprobably not due to the replacement of atopic with nonatopic immune system butpossibly due to an immune reset analogous to that observed in some autoimmunedisease patients after autologous HCT, the authors concluded. They added thatprospective trials are needed to confirm these findings.

Reference

Whiteside S, Chin A, Tripathi G, et al. Curtability and transferability of atopy with allogeneic hematopoietic cell transplantation [published online March 30, 2020]. Bone Marrow Transplant. doi: 10.1038/s41409-020-0876-7

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Atopy: Weighing Risk With the Possibility of Cure Using Hematopoietic Cell Transplantation - Hematology Advisor

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