Early relapse prediction after allogeneic hematopoietic stem cell transplantation for acute lymphoblastic leukemia (ALL) using lineage-specific chimerism analysis

eJHaem

article

Hannes Lindahl¹  Davide Valentini³  Sofie Vonlanthen¹  Mikael Sundin⁴  Andreas T. Björklund³  Stephan Mielke⁶  Dan Hauzenberger¹ 

[1] Clinical Immunology and Transfusion Medicine, Karolinska University Hospital;Department of Clinical Neuroscience, Karolinska Institutet;Department of Cellular Therapy and Allogeneic Stem Cell Transplantation ,(CAST), Karolinska University Hospital;Pediatric Hematology, Immunology and HCT, Astrid Lindgren Children's Hospital, Karolinska University Hospital;Pediatrics, CLINTEC, Karolinska Institutet;Department of Cell Therapy and Allogeneic Stem Cell Transplantation ,(CAST), Department of Laboratory Medicine ,(LabMED), Karolinska University Hospital and Institutet, Karolinska Comprehensive Cancer Center

关键词: acute leukemia;    chimerism analysis;    relapse prediction;    stem cell transplantation;   

DOI  :  10.1002/jha2.568

来源: Wiley

【 摘 要 】

Relapse is a major cause of treatment failure after hematopoietic stem cell transplantation (HSCT) for acute leukemia. Here, we report a monocentric retrospective study of all HSCTs for B cell acute lymphoblastic leukemia (ALL) performed during the years 2005–2021 ( n = 138, including 51 children), aiming to identify the optimal use of lineage-specific recipient-donor chimerism analysis for prediction of relapse. In adults, relapse was associated with increased recipient chimerism in CD3 + bone marrow cells sampled at least 30 days before a relapse. Relapse could be predicted with a sensitivity of 73% and a specificity of 83%. Results were similar for children but with a higher recipient chimerism cutoff. Additionally, adults that had at least one chimerism value <0.12% in CD3 + peripheral blood cells within the first 60 days after HSCT had 89% probability of being relapse-free after 2-years compared to 64%. Results were similar for children but again necessitating a higher chimerism cutoff. These results suggest that high-sensitive lineage-specific chimerism analysis can be used for (1) early ALL relapse prediction by longitudinal chimerism monitoring in CD3 + bone marrow cells and (2) relapse risk stratification by analyzing CD3 + blood cells early post-HSCT.

【 授权许可】

Unknown