title: Quantitative chimerism: an independent acute leukemia prognosis indicator following allogeneic hematopoietic SCT.
abstract: This study evaluates the prognostic significance of quantitative chimerism to monitor minimal residual disease and predict relapse in acute leukemia (AL) patients following allogeneic hematopoietic SCT (HSCT). The quantitative chimerism levels of 129 AL patients were measured using RQ-PCR based on 29 sequence polymorphisms. Receiver-operating characteristic curve indicated that the optimal cutoff point to predict an inevitable relapse was 1.0%, which results in 100.0% sensitivity and 79.6% specificity.The relapse rate of patients with chimerism >1.0% at 2 years was 55.0%, whereas that for patients with chimerism <1.0% was 0%(P=0.000). Quantitative chimerism >1.00% indicated a higher probability of relapse. Cox multivariate analysis indicated that quantitative chimerism >1.00% was associated with lower disease-free survival (hazard ratio (HR)=10.825; 95% confidence interval (CI) =4.704-24.912, P=0.000) and lower OS (HR=8.681; 95% CI=3.728-20.212, P=0.000). Patients (24/47 with quantitative chimerism >1.00%) who received preemptive modified DLI immunotherapy had significantly lower relapse rate (37.5%) than those (n=9) who did not (100%; P=0.001). Thus, quantitative chimerism is an independent prognostic factor that predicts clinical outcomes after HSCT and provides a guide for suitable interventions.
authors.affiliation: 1] Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China [2] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: X-Y
authors.initials: XY
authors.lastname: Qin
authors.affiliation: 1] Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China [2] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: G-X
authors.initials: GX
authors.lastname: Li
authors.affiliation: 1] Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China [2] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: Y-Z
authors.initials: YZ
authors.lastname: Qin
authors.affiliation: 1] Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China [2] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.affiliation: 1] Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China [2] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: F-R
authors.initials: FR
authors.lastname: Wang
authors.affiliation: 1] Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China [2] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: D-H
authors.initials: DH
authors.lastname: Liu
authors.affiliation: 1] Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China [2] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: L-P
authors.initials: LP
authors.lastname: Xu
authors.affiliation: 1] Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China [2] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: H
authors.initials: H
authors.lastname: Chen
authors.affiliation: 1] Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China [2] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: W
authors.initials: W
authors.lastname: Han
authors.affiliation: 1] Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China [2] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: J-Z
authors.initials: JZ
authors.lastname: Wang
authors.affiliation: 1] Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China [2] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: X-H
authors.initials: XH
authors.lastname: Zhang
authors.affiliation: 1] Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China [2] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: J-L
authors.initials: JL
authors.lastname: Li
authors.affiliation: 1] Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China [2] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: L-D
authors.initials: LD
authors.lastname: Li
authors.affiliation: 1] Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China [2] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: K-Y
authors.initials: KY
authors.lastname: Liu
authors.affiliation: 1] Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China [2] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China [3] Peking-Tsinghua Center for Life Sciences, Beijing, China.
authors.forename: X-J
authors.initials: XJ
authors.lastname: Huang
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D046528:Chimerism; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
references.citation: Exp Hematol. 2010 Dec;38(12):1261-71
references.pmid: 20851159
references.citation: Best Pract Res Clin Haematol. 2006;19(4):737-55
references.pmid: 16997180
references.citation: Cancer Treat Rev. 2010 Nov;36(7):528-38
references.pmid: 20381970
references.citation: Chin Med J (Engl). 2003 May;116(5):736-41
references.pmid: 12875692
references.citation: Lab Hematol. 2007;13(3):73-84
references.pmid: 17984038
references.citation: J Clin Oncol. 2004 May 1;22(9):1696-705
references.pmid: 15117992
references.citation: Chin Med J (Engl). 2012 Jun;125(11):1952-9
references.pmid: 22884060
references.citation: Leukemia. 2003 Jan;17(1):237-40
references.pmid: 12529686
references.citation: Blood. 2012 Apr 5;119(14):3256-62
references.pmid: 22337715
references.citation: Biol Blood Marrow Transplant. 2009 Jan;15(1 Suppl):62-71
references.pmid: 19147081
references.citation: Blood. 2000 Oct 15;96(8):2712-6
references.pmid: 11023502
references.citation: Bone Marrow Transplant. 2012 Apr;47(4):499-507
references.pmid: 21643023
references.citation: Haematologica. 2003 Jan;88(1):117-8
references.pmid: 12551838
references.citation: Science. 1997 Jun 13;276(5319):1719-24
references.pmid: 9180086
references.citation: Leuk Res. 2009 Mar;33(3):384-90
references.pmid: 18950857
references.citation: Int J Lab Hematol. 2011 Feb;33(1):57-66
references.pmid: 20681999
references.citation: Blood. 2011 Nov 17;118(20):5681-8
references.pmid: 21948300
references.citation: Leukemia. 2003 Mar;17(3):630-3
references.pmid: 12646954
references.citation: Ann Hematol. 2012 Feb;91(2):183-92
references.pmid: 21710165
references.citation: J Clin Oncol. 1997 Feb;15(2):433-44
references.pmid: 9053463
references.citation: Bone Marrow Transplant. 1998 Mar;21(5):487-95
references.pmid: 9535041
references.citation: Leukemia. 2006 Feb;20(2):365-8
references.pmid: 16331281
references.citation: Haematologica. 2007 Mar;92(3):414-7
references.pmid: 17339194
references.citation: Bone Marrow Transplant. 2000 Feb;25(4):453-6
references.pmid: 10723591
references.citation: Blood. 1998 May 15;91(10):3671-80
references.pmid: 9573003
references.citation: Blood. 2000 Mar 1;95(5):1572-9
references.pmid: 10688810
references.citation: Transpl Immunol. 2007 Apr;17(3):193-7
references.pmid: 17331846
references.citation: J Clin Invest. 2005 Nov;115(11):3093-103
references.pmid: 16224535
references.citation: Biol Blood Marrow Transplant. 2011 Jan;17(1 Suppl):S94-100
references.pmid: 21047560
references.citation: Bone Marrow Transplant. 2009 Sep;44(5):309-16
references.pmid: 19234512
references.citation: Bone Marrow Transplant. 2009 Mar;43(6):469-76
references.pmid: 18955982
references.citation: J Clin Oncol. 2003 Dec 15;21(24):4642-9
references.pmid: 14673054
references.citation: Bone Marrow Transplant. 2004 Apr;33(8):815-21
references.pmid: 14990984
references.citation: Am J Hematol. 2006 Oct;81(10):735-46
references.pmid: 16838323
references.citation: Leukemia. 2007 May;21(5):868-76
references.pmid: 17361230
references.citation: J Clin Oncol. 1989 Jan;7(1):50-7
references.pmid: 2642540
references.citation: Chin Med J (Engl). 2011 Aug;124(15):2301-8
references.pmid: 22029079
references.citation: Blood. 1995 Aug 15;86(4):1261-8
references.pmid: 7632930
references.citation: Leukemia. 1999 Dec;13(12):2079-86
references.pmid: 10602432
references.citation: Haematologica. 2004 Dec;89(12):1517-24
references.pmid: 15590404
references.citation: Leukemia. 2003 Mar;17(3):621-9
references.pmid: 12646953
references.citation: Curr Opin Hematol. 2012 Nov;19(6):454-61
references.pmid: 22918403
references.citation: Blood. 2007 Jan 1;109(1):365-73
references.pmid: 16931626
references.citation: Blood. 1995 Sep 1;86(5):2041-50
references.pmid: 7655033
references.citation: Bone Marrow Transplant. 2006 Aug;38(4):291-7
references.pmid: 16883312
references.citation: Bone Marrow Transplant. 1997 Jul;20(1):79-81
references.pmid: 9232263
references.citation: Klin Padiatr. 2002 Jul-Aug;214(4):201-5
references.pmid: 12165902
references.citation: Br J Haematol. 1988 Nov;70(3):317-20
references.pmid: 3061443
references.citation: J Clin Immunol. 2008 May;28(3):276-83
references.pmid: 18204965
references.citation: J Clin Oncol. 2002 Jan 15;20(2):405-12
references.pmid: 11786567
references.citation: Blood. 2002 Jun 15;99(12):4618-25
references.pmid: 12036896
references.citation: Blood. 1995 Dec 1;86(11):4337-43
references.pmid: 7492795
references.citation: Clin Chim Acta. 2011 Mar 18;412(7-8):625-30
references.pmid: 21185273
references.citation: Semin Oncol. 2012 Dec;39(6):653-63
references.pmid: 23206842