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. 2009 Nov;94(11):1613-7.
doi: 10.3324/haematol.2009.007765.

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

Martin Bornhäuser  1 , Uta Oelschlaegel, Uwe Platzbecker, Gesine Bug, Karin Lutterbeck, Michael G Kiehl, Johannes Schetelig, Alexander Kiani, Thomas Illmer, Markus Schaich, Catrin Theuser, Brigitte Mohr, Cornelia Brendel, Axel A Fauser, Stefan Klein, Hans Martin, Gerhard Ehninger, Christian Thiede
Affiliations

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

Martin Bornhäuser et al. Haematologica. 2009 Nov.

Abstract

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.

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Figures

Figure 1.
Figure 1.
Patients investigated at pre-defined time points. The bar graph shows how many patients were investigated at each time point specified within the protocol. In addition, the number of cases with a CD34+ donor chimerism less than 80% is provided. Finally, the filled black bars quantify the number of patients who subsequently experienced relapse.
Figure 2.
Figure 2.
(A) CD34+ donor chimerism and outcome. Patients in whom CD34+ donor chimerism dropped below 80% had a significantly higher incidence of relapse compared to cases with a stable/complete CD34+ chimerism. This was also associated with a significantly lower probability of (B) overall and (C) disease free survival.
Figure 3.
Figure 3.
CD34+ donor chimerism in the low- and high-risk group Disease free survival was influenced significantly by CD34+ donor chimerism both in (A) the low-risk and in (B) the high-risk patient cohort.
See this image and copyright information in PMC

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