Dynamics of Graft Function Measured by DNA-Technology in a Patient with Severe Aplastic Anemia and Repeated Stem Cell Transplantation

Figure 1

Donor chimerism analysis and graft function between BMT1 and BMT2. Phase 1—mixed chimerism; phase 2—graft dysfunction due to PVB19 reactivation: increasing donor T-cells and declining donor granulocytes; phase 3—autologous recovery after ATG + PBSC boost: declining donor T-cells and donor granulocytes, but stable peripheral blood counts; phase 4—mixed chimerism after PBSC boost with DLI support; phase 5—graft rejection: declining donor T-cells and granulocytes, pancytopenia; phase 6—stable T-cell and granulocyte engraftment after BMT2; BMT1: first bone marrow transplantation; BMT2: second bone marrow transplantation; ATG: antithymocyte globulin; PBSC boost: peripheral blood stem cell boost; DLI: donor lymphocyte infusion; GF: graft failure/dysfunction; GR: graft rejection; AR: autologous recovery; PVB19+: PCR-PVB19 (BM) positivity.