Konference: 2007 49th ASH Annual Meeting - účast ČR
Kategorie:
Maligní lymfomy a leukémie
Téma: Publikace ve sborníku
Číslo abstraktu: 5028
Autoři: Mgr. Ondřej Horký; prof. MUDr. Jiří Mayer, CSc.; Marek Borky; Prof. MUDr. Marta Krejčí, Ph.D.; prof. RNDr. Šárka Pospíšilová, Ph.D.; Ing. Dana Dvořáková, CSc.
The connection between chimerism status and occurence of relapse in
patients undergoing hematopoietic stem cell transplantation remains
controversial. One reason for this seems to be employment of
different methods with inherrited different sensitivity and related
definition of complete donor chimerism (CDC). We compared an
application of fragment analysis (FA) of minisatellite,
microsatellite or sex specific regions (limit of quantification 1%)
with real-time quantitative PCR (RQ-PCR) of insertion/deletion and
sex polymorphism (limit of quantification 0.1%). Long-term data
(follow-up 1.8-7.4 years, median 3.3 years) obtained from two
groups of AML patients transplanted in our centre are presented.
The first group involves 9 patients that experienced relapse (one
of them three times) whereas the second one contains 11 individuals
in complete remission. Retrospective chimerism analysis of patients
in the first group by RQ-PCR allowed prediction of hematological
relapse significantly earlier (p=0.016) than quantification by FA,
(35-448 days, median 77 days by RQ-PCR vs. 0-154 days, median 35
days by FA). Beside this, in two cases the incipient relapse was
detected only by RQ-PCR and not by FA, 118 and 70 days in advance.
Moreover, in two patients with fusion gene, there was detection of
molecular relapse recorded simultaneously by either increase of
autologous hematopoiesis or conversion of CDC to MC in
granulocytes, as revealed by analysis of sorted leukocyte subsets.
On the other hand, after achievement of CDC within the group of
patients in complete remission, the amount of detectable autologous
DNA did not repeatedly exceeded the limit of quantification of
RQ-PCR. The CDC was not achieved in one case only, whereas
lineage-restricted analysis persistently shows MC in T-lymphocytes
(1-3% of autologous origin). Our data demonstrate, that assessment
of chimerism by RQ-PCR along with analyses within specific
leukocyte subsets can provide an early indication of incipient
disease relapse of AML and could be used for residual disease
monitoring in cases, where another specific marker is not
available.The work was supported by grant MSMT CR, No.
MSM0021622430.
Abstract #5028 appears in Blood, Volume 110, issue 11, November 16,
2007
Keywords: RQ-PCR|Follow-Up|Allogeneic Bone Marrow Transplant
Disclosure: No relevant conflicts of interest to declare.
Datum přednesení příspěvku: 8. 12. 2007