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| Haematologica. 2016 Feb 11. pii: haematol.2015.135137. doi: 10.3324/haematol.2015.135137 |
| Risk assessment of relapse by lineage-specific monitoring of chimerism in children undergoing allogeneic stem cell transplantation for acute lymphoblastic leukemia. |
| Preuner S1, Peters C2, Pötschger U3, Daxberger H4, Fritsch G5, Geyeregger R6, Schrauder A7, von Stackelberg A8, Schrappe M9, Bader P10, Ebell W11, Eckert C12, Lang P13, Sykora KW14, Schrum J15, Kremens B16, Ehlert K17, Albert MH18, Meisel R19, Lawitschka A20, Mann G21, Panzer-Grümayer R22, Güngör T23, Holter W24, Strahm B25, Gruhn B26, Schulz A27, Woessmann W28, Lion T29 |
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Abstract Allogeneic hematopoietic stem cell transplantation is required as rescue therapy in about 20% of pediatric patients with acute lymphoblastic leukemia. However, the relapse rates are considerable, and confer poor outcome. Early assessment of the risk of relapse is therefore of paramount importance for the development of appropriate measures. We have used the EuroChimerism approach to investigate the potential impact of lineage-specific chimerism testing for relapse-risk analysis in 162 pediatric patients with acute lymphoblastic leukemia after allogeneic stem cell transplantation in a multicenter study based on standardized transplantation protocols. Within a median observation time of 4.5 years, relapses have occurred in 41/162 patients at a median of 0.6 years post-transplant (range: 0.13-5.7). Prospective screening at defined consecutive time points revealed that reappearance of recipient-derived cells within the CD34+ and CD8+ cell subsets display the most significant association with the occurrence of relapses with hazard ratios of 5.2 (p=0.003) and 2.8 (p=0.008), respectively. The appearance of recipient cells after a period of pure donor chimerism in the CD34+ and CD8+ leukocyte subsets revealed a dynamic indicative of significantly elevated risk of relapse or imminent disease recurrence. Assessment of chimerism within these lineages can therefore provide complementary information for further diagnostic and potentially therapeutic considerations aiming at the prevention of overt relapse. |
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Copyright © 2016, Ferrata Storti Foundation. |
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KEYWORDS: Cytogenetics and Molecular Genetics, Hematopoietic Cell Processing, Pediatric Acute Lymphoblastic Leukemia, Stem Cell Transplantation, linage-specific chimerism |
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Publikations ID: 26869631 Quelle: öffnen |
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