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Review
. 2021 Nov;82(11):838-849.
doi: 10.1016/j.humimm.2021.07.013. Epub 2021 Aug 14.

A practical guide to chimerism analysis: Review of the literature and testing practices worldwide

Amanda G Blouin  1 , Fei Ye  1 , Jenifer Williams  2 , Medhat Askar  3
Affiliations
Review

A practical guide to chimerism analysis: Review of the literature and testing practices worldwide

Amanda G Blouin et al. Hum Immunol. 2021 Nov.

Abstract

Background and purpose: Currently there are no widely accepted guidelines for chimerism analysis testing in hematopoietic cell transplantation (HCT) patients. The objective of this review is to provide a practical guide to address key aspects of performing and utilizing chimerism testing results. In developing this guide, we conducted a survey of testing practices among laboratories that are accredited for performing engraftment monitoring/chimerism analysis by either the American Society for Histocompatibility & Immunogenetics (ASHI) and/or the European Federation of Immunogenetics (EFI). We interpreted the survey results in the light of pertinent literature as well as the experience in the laboratories of the authors.

Recent developments: In recent years there has been significant advances in high throughput molecular methods such as next generation sequencing (NGS) as well as growing access to these technologies in histocompatibility and immunogenetics laboratories. These methods have the potential to improve the performance of chimerism testing in terms of sensitivity, availability of informative genetic markers that distinguish donors from recipients as well as cost.

Summary: The results of the survey revealed a great deal of heterogeneity in chimerism testing practices among participating laboratories. The most consistent response indicated monitoring of engraftment within the first 30 days. These responses are reflective of published literature. Additional clinical indications included early detection of impending relapse as well as identification of cases of HLA-loss relapse.

Keywords: Allogeneic stem cell transplant; Chimerism analysis; Engraftment; Leukemia; Relapse.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Askar has received compensation as a member of the scientific advisory board for CareDx, Inc. Dr. Blouin, Dr. Ye, and Ms. Williams declare no potential competing interests.

References

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