Predictors of Outcomes after Allogeneic Hematopoietic Cell Transplantation (HCT)

Allogeneic hematopoietic cell transplant (HCT) is the treatment of choice for many severe life-threatening malignant or non-malignant diseases of the hematopoietic system. Despite significant improvement in survival after HCT, patients still suffer high mortality and morbidity risk from disease relapse or transplant-related complications.

Overview

Studies in the Clinical Genetics Branch aim to improve patient survival by identifying biomarkers that can guide donor selection or refine patient risk stratification. Ongoing research includes patients receiving HCT for severe aplastic anemia or myeloid neoplasms.

Study Team

Shahinaz Gadalla, M.D., Ph.D., senior investigator, Clinical Genetics Branch

Collaborators

Cancer Survivorship Research Unit (CSRU)

Select Findings & Publications

In the first study to evaluate donor cell telomere length and outcomes after hematopoietic cell transplant (HCT), investigators found that among patients with severe aplastic anemia (SAA) who received a from an unrelated donor, those whose donor white blood cells had longer telomeres had higher survival rates five-years after transplantation than those whose donor white blood cells had shorter telomeres. By contrast, the length of telomeres in a patient’s own white blood cells, as measured before transplantation, was not associated with survival.

Individuals who receive HCT for treatment of SAA can benefit from genetic testing prior to treatment initiation to determine if they have an unrecognized inherited bone marrow failure syndrome.

Select Publications

Brown D et al. Germline-somatic JAK2 interactions are associated with clonal expansion in myelofibrosis. Nature Comms 2022.

Gadalla SM et al. Association of donor IFNL4 genotype and non-relapse mortality after unrelated donor myeloablative haematopoietic stem-cell transplantation for acute leukaemia: a retrospective cohort study. Lancet Haematology 2020.