title: Donor Chimerism of B Cells and Nature Killer Cells Provides Useful Information to Predict Hematologic Relapse following Allogeneic Hematopoietic Stem Cell Transplantation.
abstract: In this study we investigated the correlation between donor chimerism status and disease relapse following allogeneic hematopoietic stem cell transplantation (allo-HSCT). The chimerism of Fluorescence-activated cell sorter (FACS) sorted CD3+T lymphocytes of 153 cases, CD56+CD16+NK lymphocytes of 153 cases and CD19+B lymphocytes of 31 cases with acute B lymphoblastic leukemia (B-ALL) was analyzed post-transplant utilizing polymerase chain reaction amplification of short tandem repeats (PCR-STR). A total of 33 patients (33/153, 21.6%) had recurrent disease. The positive predictive values of declining donor chimerism for hematologic and isolated extramedullary relapse were 58.8% and 10% (P=0.018, Chi-Square). The positive predictive values of declining donor chimerism in BMB, BMT, BMNK and PBB for hematologic relapse were 11.6%, 0%, 0% and 0% under close monitoring in patients with B-ALL. Only the donor chimerism in BMB significantly decreased in the group with hematologic relapse as compared with the group without hematologic relapse (P=0.00, Independent-samples T test) in patients with B-ALL. The median drop of donor chimerism in PBT, BMT, PBNK and BMNK were 0%, 0%, 5.9% and 2.8% one or two weeks prior to hematologic relapse in patients with non-B-ALL. The donor chimerism in PBNK significantly decreased prior to hematologic relapse in the group with hematologic relapse as compared with the group without hematologic relapse (P=0.022, Independent-samples T test).These data suggest donor chimerism of BMB can be used to predict the occurrence of hematologic relapse in patients with B-ALL. Donor chimerism decrease in PBNK was associated with a somewhat increased risk of hematologic relapse in patients with non-B-ALL. Therefore, our results reveal a more effective path to individually predict for hematologic relapse by dynamic monitoring different cell lineages in different disease.
authors.affiliation: Department of Hematology, Shanghai First People's Hospital, Medical College, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Hematology, Shanghai First People's Hospital, Medical College, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Wan
authors.affiliation: Department of Hematology, Shanghai First People's Hospital, Medical College, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Youwen
authors.initials: Y
authors.lastname: Qin
authors.affiliation: Department of Hematology, Shanghai First People's Hospital, Medical College, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Xiaorui
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Hematology, Shanghai First People's Hospital, Medical College, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Shike
authors.initials: S
authors.lastname: Yan
authors.affiliation: Department of Central Laboratory, Shanghai First People's Hospital, Medical College, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Kuangcheng
authors.initials: K
authors.lastname: Xie
authors.affiliation: Department of Hematology, Shanghai First People's Hospital, Medical College, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D001402:B-Lymphocytes / Q000276:immunology*; D002648:Child; D046528:Chimerism; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology; D012008:Recurrence; D013601:T-Lymphocytes / Q000276:immunology; D014019:Tissue Donors; D018183:Transplantation Chimera / Q000276:immunology*; D014184:Transplantation, Homologous / Q000379:methods; D055815:Young Adult