BACKGROUND AND OBJECTIVES: The role of hematopoietic chimerism after allogeneic stem cell transplantation (SCT) for acute leukemia remains controversial. We studied the relationship between hematopoietic chimerism and several prognostic variables on the outcome of SCT in patients with acute leukemia. DESIGN AND METHODS: Chimerism was determined by a semiquantitative method, based on polymerase chain reaction (PCR) amplification of variable number tandem repeat (VNTR) minisatellites, in 133 consecutive patients who underwent allogeneic SCT for acute leukemia (68 myeloid, 58 lymphoid and 7 biphenotypic), all receiving a myeloablative conditioning regimen. RESULTS: The median follow-up for the surviving patients was 44.8 months (range: 12.0-129.0). Recipient hematopoiesis (mixed chimerism, MC) was detected in 40 cases (30.1%). Two types of patients could be distinguished in this MC group: 29 with increasing MC and 9 with decreasing MC. The remaining 93 cases maintained complete donor chimerism (CC) over the whole follow-up period. Patients with increasing MC showed a significantly higher (p<0.001) rate of relapse (93.1%) and death (89.7%) in comparison to both those with CC (26.9% relapse, 44.1% dead) or decreasing MC (11.1% relapse, 44.4% dead). The detection of increasing MC preceded relapse by a median of 74 days (range: 5-434) and was significantly related with the absence of chronic graft-versus-host disease. Univariate and multivariate analysis confirmed that chimerism was the most significant variable involved in relapse, leukemia-free survival and overall survival after SCT. INTERPRETATION AND CONCLUSIONS: These results demonstrate that sequential determination of chimerism allows the prediction of relapse and death after SCT for acute leukemia. The interval between detection of increasing MC and relapse may permit timely implementation of therapeutic measures.
BACKGROUND AND OBJECTIVES: The role of hematopoietic chimerism after allogeneic stem cell transplantation (SCT) for acute leukemia remains controversial. We studied the relationship between hematopoietic chimerism and several prognostic variables on the outcome of SCT in patients with acute leukemia. DESIGN AND METHODS: Chimerism was determined by a semiquantitative method, based on polymerase chain reaction (PCR) amplification of variable number tandem repeat (VNTR) minisatellites, in 133 consecutive patients who underwent allogeneic SCT for acute leukemia (68 myeloid, 58 lymphoid and 7 biphenotypic), all receiving a myeloablative conditioning regimen. RESULTS: The median follow-up for the surviving patients was 44.8 months (range: 12.0-129.0). Recipient hematopoiesis (mixed chimerism, MC) was detected in 40 cases (30.1%). Two types of patients could be distinguished in this MC group: 29 with increasing MC and 9 with decreasing MC. The remaining 93 cases maintained complete donor chimerism (CC) over the whole follow-up period. Patients with increasing MC showed a significantly higher (p<0.001) rate of relapse (93.1%) and death (89.7%) in comparison to both those with CC (26.9% relapse, 44.1% dead) or decreasing MC (11.1% relapse, 44.4% dead). The detection of increasing MC preceded relapse by a median of 74 days (range: 5-434) and was significantly related with the absence of chronic graft-versus-host disease. Univariate and multivariate analysis confirmed that chimerism was the most significant variable involved in relapse, leukemia-free survival and overall survival after SCT. INTERPRETATION AND CONCLUSIONS: These results demonstrate that sequential determination of chimerism allows the prediction of relapse and death after SCT for acute leukemia. The interval between detection of increasing MC and relapse may permit timely implementation of therapeutic measures.
Authors: Hans C Lee; Rima M Saliba; Gabriela Rondon; Julianne Chen; Yasmeen Charafeddine; L Jeffrey Medeiros; Gheath Alatrash; Borje S Andersson; Uday Popat; Partow Kebriaei; Stefan Ciurea; Betul Oran; Elizabeth Shpall; Richard Champlin Journal: Biol Blood Marrow Transplant Date: 2015-07-14 Impact factor: 5.742
Authors: Klaus Wethmar; Svenja Matern; Eva Eßeling; Linus Angenendt; Heike Pfeifer; Monika Brüggemann; Patrick Stelmach; Simon Call; Jörn C Albring; Jan-Henrik Mikesch; Christian Reicherts; Christoph Groth; Christoph Schliemann; Wolfgang E Berdel; Georg Lenz; Matthias Stelljes Journal: Bone Marrow Transplant Date: 2020-01-30 Impact factor: 5.483
Authors: Merav Bar; Mary E D Flowers; Barry E Storer; Thomas R Chauncey; Michael A Pulsipher; Monica S Thakar; Wolfgang Bethge; Rainer Storb; David G Maloney; Brenda M Sandmaier Journal: Biol Blood Marrow Transplant Date: 2017-10-12 Impact factor: 5.742
Authors: Christian Bach; Elmira Tomova; Katja Goldmann; Volker Weisbach; Wolf Roesler; Andreas Mackensen; Julia Winkler; Bernd M Spriewald Journal: Transfus Med Hemother Date: 2014-12-22 Impact factor: 3.747
Authors: N Jacque; S Nguyen; J-L Golmard; M Uzunov; A Garnier; V Leblond; J-P Vernant; D Bories; N Dhédin Journal: Bone Marrow Transplant Date: 2014-11-10 Impact factor: 5.483
Authors: Nicolaus Kröger; Ulrike Bacher; Peter Bader; Sebastian Böttcher; Michael J Borowitz; Peter Dreger; Issa Khouri; Homer A Macapinlac; Homer Macapintac; Eduardo Olavarria; Jerald Radich; Wendy Stock; Julie M Vose; Daniel Weisdorf; Andre Willasch; Sergio Giralt; Michael R Bishop; Alan S Wayne Journal: Biol Blood Marrow Transplant Date: 2010-06-14 Impact factor: 5.742
Authors: Jörn Erlecke; Isabell Hartmann; Martin Hoffmann; Torsten Kroll; Heike Starke; Anita Heller; Alexander Gloria; Herbert G Sayer; Tilman Johannes; Uwe Claussen; Thomas Liehr; Ivan F Loncarevic Journal: Mol Cytogenet Date: 2009-05-29 Impact factor: 2.009