Haematologica, Vol 94, Issue 11, 1613-1617 doi:10.3324/haematol.2009.007765
Copyright © 2009 by Ferrata Storti Foundation
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Stem Cell Transplantation

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

Martin Bornhäuser1, Uta Oelschlaegel1, Uwe Platzbecker1, Gesine Bug2, Karin Lutterbeck1, Michael G. Kiehl3, Johannes Schetelig1, Alexander Kiani1, Thomas Illmer1, Markus Schaich1, Catrin Theuser1, Brigitte Mohr1, Cornelia Brendel4, Axel A. Fauser3, Stefan Klein2, Hans Martin2, Gerhard Ehninger1, Christian Thiede1

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.