title: Monitoring of donor chimerism in sorted CD34+ peripheral blood cells allows the sensitive detection of imminent relapse after allogeneic stem cell transplantation.
abstract: Analysis of donor chimerism is an important diagnostic tool to assess the risk of relapse after allogeneic stem cell transplantation, especially in patients lacking a specific marker suitable for monitoring of minimal residual disease. We prospectively investigated the predictive value of donor chimerism analyses in sorted CD34(+) peripheral blood cells in 90 patients with acute leukemia and myelodysplastic syndrome. The cumulative incidence of relapse after four years was significantly increased in cases with decreasing or incomplete CD34(+) donor chimerism (57% vs. 18%, p=0.0001). Multivariate analysis confirmed decreasing CD34(+) donor chimerism as an independent predictor of relapse and inferior survival. The interval between a decrease of CD34(+) chimerism of less than 80% and hematologic relapse was 61 days (range 0-567). Monitoring of CD34(+) donor chimerism in the peripheral blood allows prediction of imminent relapse after allogeneic stem cell transplantation even when a disease-specific marker is lacking.
authors.affiliation: Medizinische Klinik und Poliklinik I, University Hospital, Dresden, Germany. martin.bornhaeuser@uniklinikum-dresden.de
authors.forename: Martin
authors.initials: M
authors.lastname: Bornhäuser
authors.forename: Uta
authors.initials: U
authors.lastname: Oelschlaegel
authors.forename: Uwe
authors.initials: U
authors.lastname: Platzbecker
authors.forename: Gesine
authors.initials: G
authors.lastname: Bug
authors.forename: Karin
authors.initials: K
authors.lastname: Lutterbeck
authors.forename: Michael G
authors.initials: MG
authors.lastname: Kiehl
authors.forename: Johannes
authors.initials: J
authors.lastname: Schetelig
authors.forename: Alexander
authors.initials: A
authors.lastname: Kiani
authors.forename: Thomas
authors.initials: T
authors.lastname: Illmer
authors.forename: Markus
authors.initials: M
authors.lastname: Schaich
authors.forename: Catrin
authors.initials: C
authors.lastname: Theuser
authors.forename: Brigitte
authors.initials: B
authors.lastname: Mohr
authors.forename: Cornelia
authors.initials: C
authors.lastname: Brendel
authors.forename: Axel A
authors.initials: AA
authors.lastname: Fauser
authors.forename: Stefan
authors.initials: S
authors.lastname: Klein
authors.forename: Hans
authors.initials: H
authors.lastname: Martin
authors.forename: Gerhard
authors.initials: G
authors.lastname: Ehninger
authors.forename: Christian
authors.initials: C
authors.lastname: Thiede
mesh_terms: D018952:Antigens, CD34; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D007938:Leukemia / Q000175:diagnosis / Q000401:mortality; D025202:Molecular Diagnostic Techniques; D018365:Neoplasm, Residual / Q000175:diagnosis*; D011446:Prospective Studies; D012008:Recurrence; D016019:Survival Analysis; D018183:Transplantation Chimera; D014184:Transplantation, Homologous
chemical_list: D018952:Antigens, CD34