Monitoring of donor chimerism in sorted CD34+ peripheral blood cells allows the sensitive detection of imminent relapse after allogeneic stem cell transplantation

被引：94

作者：

Bornhaeuser, Martin ^{[1
]}

Elschlaegel, Uta ^{[1
]}

Platzbecker, Uwe ^{[1
]}

Bug, Gesine ^{[2
]}

Lutterbeck, Karin ^{[1
]}

Kiehl, Michael G. ^{[3
]}

Schetelig, Johannes ^{[1
]}

Kiani, Alexander ^{[1
]}

Illmer, Thomas ^{[1
]}

Schaich, Markus ^{[1
]}

Theuser, Catrin ^{[1
]}

Mohr, Brigitte ^{[1
]}

Brendel, Cornelia ^{[4
]}

Fauser, Axel A. ^{[3
]}

Klein, Stefan ^{[2
]}

Martin, Hans ^{[2
]}

Ehninger, Gerhard ^{[1
]}

Thiede, Christian ^{[1
]}

机构：

[1] Univ Klinikum Carl Gustav Carus, Med Klin & Poliklin 1, Univ Hosp, D-01307 Dresden, Germany

[2] Med Klin 2, Frankfurt, Germany

[3] Bone Marrow Transplantat Clin, Idar Oberstein, Germany

[4] Innere Med Klin, Marburg, Germany

来源：

HAEMATOLOGICA-THE HEMATOLOGY JOURNAL | 2009年 / 94卷 / 11期

关键词：

donor chimerism; cell sorting; CD34(+); allogeneic stem cell transplantation; relapse; leukemia; ACUTE MYELOID-LEUKEMIA; MINIMAL RESIDUAL DISEASE; BONE-MARROW-TRANSPLANTATION; TANDEM REPEAT-MARKERS; MYELODYSPLASTIC SYNDROME; MIXED CHIMERISM; GM-CSF; AMPLIFICATION; PREDICTION;

D O I：

10.3324/haematol.2009.007765

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

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.

引用

页码：1613 / 1617

页数：5

共 21 条

[1]

Quantitative monitoring of NPM1 mutations provides a valid minimal residual disease parameter following allogeneic stem cell transplantation [J].

Bacher, Ulrike ;

Badbaran, Anita ;

Fehse, Boris ;

Zabelina, Tatjana ;

Zander, Axel Rolf ;

Kroeger, Nicolaus .

EXPERIMENTAL HEMATOLOGY, 2009, 37 (01) :135-142

[2]

Kinetics of the graft-versus-leukemia response after donor leukocyte infusions for relapsed chronic myeloid leukemia after allogeneic bone marrow transplantation [J].

Baurmann, H ;

Nagel, S ;

Binder, T ;

Neubauer, A ;

Siegert, V ;

Huhn, D .

BLOOD, 1998, 92 (10) :3582-3590

[3]

Lenalidomide as induction therapy before allogeneic stem cell transplantation in a patient with proliferative CMML-2 and del(5q) not involving the EGR1 locus [J].

Carus, Gustav .

LEUKEMIA, 2007, 21 (11) :2384-2385

[4]

Hematopoietic cell transplantation in patients with myelodysplastic syndrome or acute myeloid leukemia arising from myelodysplastic syndrome: similar outcomes in patients with de novo disease and disease following prior therapy or antecedent hematologic disorders [J].

Chang, ChunKang ;

Storer, Barry E. ;

Scott, Bart L. ;

Bryant, Eileen M. ;

Shulman, Howard M. ;

Flowers, Mary E. ;

Sandmaier, Brenda M. ;

Witherspoon, Robert P. ;

Nash, Richard A. ;

Sanders, Jean E. ;

Bedalov, Antonio ;

Hansen, John A. ;

Clurman, Bruce E. ;

Storb, Rainer ;

Appelbaum, Frederick R. ;

Deeg, H. Joachim .

BLOOD, 2007, 110 (04) :1379-1387

[5]

Successful treatment of relapsed AML after allogeneic stem cell transplantation with azacitidine [J].

Graef, Thorsten ;

Kuendgen, Andrea ;

Fenk, Roland ;

Zohren, Fabian ;

Haas, Rainer ;

Kobbe, Guido .

LEUKEMIA RESEARCH, 2007, 31 (02) :257-259

[6]

NONPARAMETRIC-ESTIMATION FROM INCOMPLETE OBSERVATIONS [J].

KAPLAN, EL ;

MEIER, P .

JOURNAL OF THE AMERICAN STATISTICAL ASSOCIATION, 1958, 53 (282) :457-481

[7]

Monitoring of minimal residual disease in acute myeloid leukemia [J].

Kern, Wolfgang ;

Haferlach, Claudia ;

Haferlach, Torsten ;

Schnittger, Susanne .

CANCER, 2008, 112 (01) :4-16

[8]

Lin DY, 1997, STAT MED, V16, P901, DOI 10.1002/(SICI)1097-0258(19970430)16:8<901::AID-SIM543>3.0.CO

[9]

2-M

[10]

Leukemia lineage-specific chimerism analysis is a sensitive predictor of relapse in patients with acute myeloid leukemia and myelodysplastic syndrome after allogeneic stem cell transplantation [J].

Mattsson, J ;

Uzunel, M ;

Tammik, L ;

Aschan, J ;

Ringdén, O .

LEUKEMIA, 2001, 15 (12) :1976-1985

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