Stem Cell Transplantation |
1 Medizinische Klinik und Poliklinik I, University Hospital, Dresden
2 Medizinische Klinik II, Hematology/Oncology, Frankfurt
3 Bone Marrow Transplantation Clinic, Idar Oberstein
4 Klinik für Innere Medizin, Schwerpunkt Hämatologie/Onkologie, Marburg, Germany
Correspondence: Martin Bornhäuser, MD, Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Fetscherstrasse 74, 01307 Dresden, Germany. E-mail:martin.bornhaeuser{at}uniklinikum-dresden.de
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.
Key words: donor chimerism, cell sorting, CD34+, allogeneic stem cell transplantation, relapse, leukemia.