Monitoring of donor chimerism in sorted CD34+ peripheral blood cells allows the sensitive detection of imminent relapse after allogeneic stem cell transplantation.
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.
Bornhäuser
Martin
M
Medizinische Klinik und Poliklinik I, University Hospital, Dresden, Germany. martin.bornhaeuser@uniklinikum-dresden.de
Oelschlaegel
Uta
U
Platzbecker
Uwe
U
Bug
Gesine
G
Lutterbeck
Karin
K
Kiehl
Michael G
MG
Schetelig
Johannes
J
Kiani
Alexander
A
Illmer
Thomas
T
Schaich
Markus
M
Theuser
Catrin
C
Mohr
Brigitte
B
Brendel
Cornelia
C
Fauser
Axel A
AA
Klein
Stefan
S
Martin
Hans
H
Ehninger
Gerhard
G
Thiede
Christian
C
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
D018952:Antigens, CD34