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Chimerism analysis – critical diagnostic tool for the outcome assessment of allogeneic hematopoietic stem cell transplantation
Cristian Jinca, Valentin Ordodi, Smaranda Arghirescu, Jijo John, Anca Isac, Luca Dehelean, Margit Şerban
Abstract: Purpose of the study. The method used for the investigation of the presence of donor cells in the host after allogeneic hematopoietic stem cell transplantation (HSCT) is represented by the chimerism analysis. In this retrospective study, the objective was to evaluate the predictive value of chimerism analysis for the post-transplant outcome. Material and methods. The study was conducted on a lot of 16 patients who underwent allogeneic HSCT in the Centre for Bone Marrow Transplantation Timişoara. Chimerism was prospectively analyzed on days: + 30, +90, +180, + 270, +365 post-transplant. In six patients the investigation was done by fluorescent in situ hybridization whereas the rest were analyzed by means of real-time PCR. One patient died prior to the first chimerism assessment. Results. In 7 patients, the evolution towards a complete donor chimerism occured within the first six months post-transplant. In 3 patients, the last performed analysis revealed a progressive varied chimerism at least for one lineage, pattern which turned out to be highly predictive for the unfavorable outcome for two of them. Granulocytes, monocytes and CD 19 lymphocytes were 96 – 100 % donor cells already on day + 30 in the majority of patients. Discussion and conclusions. The two methods used for the assessment of chimerism offer predictive information for the outcome. Our patients with progressive mixed chimerism presented an unfavorable clinical outcome as compared to those with a full donor chimerism who were in complete remission at the time of evaluation.
Keywords: Hematopoietic stem cell transplantation,chimerism,polymerase chain reaction,fluorescent in situ hybridization.
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Jinca C, Ordodi V, Arghirescu S, John J, Isac A, Dehelean L, et al. Chimerism analysis – critical diagnostic tool for the outcome assessment of allogeneic hematopoietic stem cell transplantation. Rev Romana Med Lab. 2009;15(2):17-25
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