[Clinical significance of dynamic monitoring of cell chimerism following allogeneic hematopoietic stem cell transplantation].
OBJECTIVE
To evaluate the relationship of chimerism status of cell subsets with engraftment, occurrence of acute graft versus host disease (aGVHD), graft rejection and disease relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT).


METHODS
Chimerism status in peripheral blood (PB) and bone marrow (BM) of 65 patients received allo-HSCT were monitored at regular intervals post-transplant. Fluorescence-activated cell sorter (FACS) was used to sort CD3(+)T lymphocytes in 65 cases, CD3(-)CD56(+)CD16(+)NK cells in 52 cases, CD15(+) granulocytes in 32 cases and CD19(+)B lymphocytes in 20 cases post transplants. The chimerism status of different lineage cells was analyzed by polymerase chain reaction amplification of short tandem repeats (PCR-STR).


RESULTS
On day +7, NK-cells donor chimerism (DC 55.5%) was higher than other cell subsets. T lymphocyte was the latest one to reach complete donor chimerism (CDC) with a median on day +21. Patients whose T lymphocytes donor chimerism was more than 70% on day +7 and more than 95% on day +14 had a high risk for acute aGVHD. In all cases except those with ALL, the decreased DC of T lymphocytes were observed before molecular or hematological relapse occurred.


CONCLUSIONS
Serial and quantitative T cell chimerism analysis provides a reliable and rapid screening method for the early detection of engraftment, graft rejection, disease relapse and occurrence of aGVHD, therefore, is a prognostic tool to identify patients at high risk of aGVHD and disease relapse following allo-HSCT.
Jiang
Ying
Y
Shanghai Jiaotong University Affiliated No.1 People Hospital, Shanghai 200080, China.
Wan
Li-Ping
LP
Wang
Chun
C
Yan
Shi-Ke
SK
Gao
Yan-Rong
YR
Jiang
Jie-Ling
JL
Yang
Juan
J
Cai
Yu
Y
Bai
Hai-Tao
HT
Wei
Dao-Lin
DL
Xie
Kuang-Cheng
KC
D000293:Adolescent; D000328:Adult; D002648:Child; D046528:Chimerism; D005260:Female; D006084:Graft Rejection / Q000276:immunology; D006086:Graft vs Host Disease / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013601:T-Lymphocytes / Q000276:immunology*; D055815:Young Adult