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Post-Transplant Events

Chimerism analysis within 6 months of allogeneic stem cell transplantation predicts relapse in acute myeloid leukemia

Bone Marrow Transplantation volume 39, pages 285–291 (2007)Cite this article

Abstract

The role of chimerism analysis as a prognostic indicator of relapse after hematopoietic stem cell transplantation (SCT) is controversial. We monitored chimerism status by short tandem repeat-based polymerase chain reaction (PCR) in T- and non-T-cell subsets and retrospectively evaluated clinical outcome in 96 patients with acute myeloid leukemia after myeloablative (MA) or reduced-intensity conditioning SCT. Fifty-six percent of 80 patients in the MA group demonstrated complete donor chimerism (CC) at all time points, whereas 6% had decreasing mixed chimerism (MC), 8% stable MC, 25% increasing MC and 3% increasing and decreasing MC. In 16 RIC patients, these percentages were 12, 50, 6, 6 and 19, respectively, together with 6% nonengraftment. Forty-three out of 96 patients experienced relapse. The last chimerism evaluation before relapse revealed increasing MC in only eight patients. In samples taken between 1 and 6 months post SCT, CC/decreasing MC was significantly related with a lower risk of relapse (31 versus 83%, P<0.000) and mortality (38 versus 83%, P<0.000) than with MC/increasing MC. However, the development of relapse was very rapid. Only very frequent monitoring of chimerism status by highly sensitive methods might identify impending relapse and allow early immunological intervention.

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Acknowledgements

We thank Dr P Westers, statistician at the Center for Biostatistics, for his help in the statistical analysis of this study. We are also grateful to Dr E Meijer, M Gerrits and J van der Giessen (Department of Hematology, University Medical Center Utrecht) for providing data. J van Loon and WTM van Blokland are gratefully acknowledged for their contribution in the STR analysis.

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Authors and Affiliations

  1. Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands

    C Huisman & L F Verdonck

  2. Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands

    R A de Weger, L de Vries & M G J Tilanus

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  1. C Huisman
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  2. R A de Weger
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  3. L de Vries
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  4. M G J Tilanus
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Correspondence to C Huisman.

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Huisman, C., de Weger, R., de Vries, L. et al. Chimerism analysis within 6 months of allogeneic stem cell transplantation predicts relapse in acute myeloid leukemia. Bone Marrow Transplant 39, 285–291 (2007). https://doi.org/10.1038/sj.bmt.1705582

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