Serial quantification of lymphoid and myeloid mixed chimerism using multiplex PCR amplification of short tandem repeat-markers predicts graft rejection and relapse, respectively, after allogeneic transplantation of CD34+selected cells from peripheral blood

被引:41
作者
Fernández-Avilés, F
Urbano-Ispizua, A
Aymerich, M
Colomer, D
Rovira, M
Martínez, C
Nadal, E
Talarn, C
Carreras, E
Montserrat, E
机构
[1] Univ Barcelona, Inst Haematol & Oncol, Hosp Clin Barcelona, E-08036 Barcelona, Spain
[2] Univ Barcelona, Haematopathol Unit, IDIBAPS, Postgrad Sch Haematol Farreras Valenti,Hosp Clin, Barcelona, Spain
关键词
chimerism; PCR/STR; CD34(+) selection; T-cell depletion;
D O I
10.1038/sj.leu.2402854
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
We used multiplex amplification of nine microsatellite sequences (PCR-STR) to analyse chimerism in pure populations of T cells and neutrophils from peripheral blood from 40 patients submitted to an allogeneic transplant, 22 having received a T-cell depleted (TCD) peripheral blood graft by means of CD34(+) selection (allo-PBT/CD34(+)), and 18, an unmodified graft (allo-SCT; 13 allogeneic bone marrow transplants and five allo-PBT). T-cell mixed chimerism (TcMC) was observed in 16 of the 22 (72.3%) patients receiving an allo-PBT/ CD34(+), but in only one of the 18 (5.5%) patients receiving an allo-SCT (P = 0.0001). TcMC was transient (n = 6), stable (n = 7), and associated with poor haematopoietic engraftment (n = 4). All patients with TcMC who developed graft failure had more than 30% of host T cells. Myeloid MC (MyMC) was observed in four (19%) allo-PBT/CD34(+) patients and in three (17%) allo-SCT patients (P = NS). Five out of seven (71%) patients with MyMC relapsed, all of them diagnosed with myeloid malignancies, as compared with two of the 20 (10%) patients with complete donor chimerism (P<0.0001). In conclusion, TcMC appears in a significant number of allo-PBT/CD34(+) patients and may be associated with poor engraftment when the percentage of host T cells is >30%; likewise, MyMC appears in a small percentage of recipients of both allo-PBT/CD34(+) and allo-SCT patients and is associated with leukaemia relapse in myeloid malignancies.
引用
收藏
页码:613 / 620
页数:8
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