title: Evaluation of chimerism by quantitative PCR analysis of DNA polymorphism after allogeneic hematopoietic stem cell transplantation in a pediatric population with malignancies.
abstract: Relapse remains the major pitfall to success for Allo-HSCT in children with malignancies. Ninety-one patients undergoing Allo-HSCT were retrospectively reviewed. Chimerism status was evaluated at days +30, +60, and +100 in PB. VNTR-PCR and STR-PCR were used for this purpose. Thirty-one patients recurred (34%) and none survived. Thirty-two remain alive in CR (35%). Patients who achieved a CC at those days had a significant higher RFS and OS than patients who did not. Twelve patients showing PMC had an increased risk of recurrence (p=0.02. OR 7.7). In the univariate analysis, the probability of death was higher in patients who were not in first CR before transplant (p=0.008.OR 2.09) and in those receiving cells not from PB (p=0.002.OR 2.03). In the multivariate analysis, the absence of CC at day +100 was associated with a higher probability of relapse (p=0.004. OR 10.8) and death (p=0.016. OR 9.3). Serial chimerism PCR-based analyses of polymorphic DNA markers can predict relapse. Patients with PMC are at the highest risk of recurrence. Patients receiving an Allo-HSCT in first CR from PB who achieve a CC at day +100 have a better outcome.
authors.affiliation: Pediatric Oncology Unit, Hospital Universitario La Fe, Valencia, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Bautista
authors.forename: L
authors.initials: L
authors.lastname: Moreno
authors.forename: J M
authors.initials: JM
authors.lastname: Fernández-Navarro
authors.forename: L
authors.initials: L
authors.lastname: Senent
authors.forename: M M
authors.initials: MM
authors.lastname: Andrés
authors.forename: V
authors.initials: V
authors.lastname: Castel
authors.forename: A
authors.initials: A
authors.lastname: Verdeguer
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D046528:Chimerism; D004247:DNA / Q000235:genetics*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D016133:Polymerase Chain Reaction / Q000379:methods*; D011110:Polymorphism, Genetic; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014184:Transplantation, Homologous / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D004247:DNA