Chimerism analysis in peripheral blood using indel quantitative real-time PCR is a useful tool to predict post-transplant relapse in acute leukemia
| Autor: | N Jacque, J P Vernant, Veronique Leblond, Madalina Uzunov, Nathalie Dhedin, Stéphanie Nguyen, Dominique Bories, J-L Golmard, Alice Garnier |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Myeloid Adolescent Real-Time Polymerase Chain Reaction Recurrence medicine Humans Indel Aged Retrospective Studies Transplantation Acute leukemia Transplantation Chimera business.industry food and beverages Hematology Middle Aged Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Allografts Peripheral blood Leukemia Leukemia Myeloid Acute Real-time polymerase chain reaction medicine.anatomical_structure Graft-versus-host disease Immunology Female business Stem Cell Transplantation |
| Zdroj: | Bone marrow transplantation. 50(2) |
| ISSN: | 1476-5365 |
| Popis: | Detection of increasing mixed chimerism (IMC) using standard PCR correlates with relapse after allo-SCT for acute leukemias (ALs). Quantitative real-time PCR of insertion/deletion polymorphism (indel qrtPCR) is a much more sensitive method, which can be performed on peripheral blood. We studied the significance of low increases of recipient cells (0.1%) detected by indel qrtPCR in a cohort of 89 transplants. We did not observe relapse among the 32 patients with no IMC. Fifty-seven patients presented a first IMC, which was followed by four different scenarios: a decreasing MC (26 cases, no relapse), a stable MC (1 case, 1 relapse), a second IMC (24 cases, 15 relapse) or no control of chimerism (6 cases, 5 relapses). In multivariate analysis, detection of two successive IMCs was strongly associated with relapse (hazard ratio (HR): 9.4, 95% confidence interval (CI): 3.8-23; P0.0001). Among the 57 patients who presented at least one IMC, 27 underwent immunomodulation (tapering of immunosuppression or donor lymphocyte injection), leading to a 1-year relapse rate of 15.7% vs 57.6% in the 30 other patients (P=0.0007). Altogether, these results indicate that chimerism analysis using indel qrtPCR in peripheral blood is a useful tool for detection of relapse in patients transplanted for AL. |
| Databáze: | OpenAIRE |
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