Prevalence of chimerism after non-myeloablative hematopoietic stem cell transplantation

Sao Paulo Medical Journal

Azulamara Da Silva Ruiz²  Maria De Lourdes Ferrari Chauffaille¹  Solivanda Trindade Alves¹  José Salvador Rodrigues De Oliveira¹ 

[1],Universidade Federal de São Paulo Escola Paulista de Medicina Division of Hematology and Transfusion MedicineSão Paulo,Brazil

关键词: Variable number of tandem repeats;    Hematologic neoplasms;    Bone marrow transplantation;    In situ hybridization;    fluorescence;    Chimerism;    Leukemia;    Repetições mini-satélites;    Neoplasia hematológicas;    Transplante de medula óssea;    Hibridização in situ fluorescente;    Quimerismo;    Leucemia;   

DOI  :  10.1590/S1516-31802009000500002

来源: SciELO

【 摘 要 】

CONTEXT AND OBJECTIVE: Non-myeloablative hematopoietic stem cell transplantation (NMA-HSCT) is performed in onco-hematological patients who cannot tolerate ablative conditioning because of older age or comorbidities. This approach does not completely eliminate host cells and initially results in mixed chimerism. Long-term persistence of mixed chimerism results in graft rejection and relapse. Involvement of graft-versus-host disease is concomitant with complete chimerism and graft-versus-tumor effect. The aim of this study was to evaluate the prevalence of chimerism in onco-hematological patients who underwent NMA-HSCT. DESIGN AND SETTING: Observational clinical study on chimerism status after human leukocyte antigen-identical NMA-HSCT at the Discipline of Hematology and Hemotherapy of Universidade Federal de São Paulo. METHODS: We sequentially analyzed the amplification of APO-B, D1S80, DxS52, FVW, 33.6, YNZ-2 and H-ras primers using variable number of tandem repeats (VNTR) on 17 pairs and fluorescent in situ hybridization (FISH) with the XY probe and SRY primer on 13 sex-unmatched pairs. RESULTS: The informativeness of the primers using VNTR was 60% for APO-B, 75% D1S80, 36% DxS52, 14% FVW, 40% YNZ-22 and 16% H-ras. The SRY primer was informative in female receptors with male donors. The XY-FISH method was informative in 100% of the sex-unmatched pairs. CONCLUSION: These methods were sensitive and informative. In VNTR, the association of APO-B with D1S80 showed 88% informativeness. The quantitative FISH method was more sensitive, but had the disadvantage of only being used for sex-unmatched pairs.

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