Mikrochimérismus - na hraně počínajícího relapsu AML?
| Title in English | Microchimerism - on the edge of incipient AML relapse? |
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| Authors | |
| Year of publication | 2009 |
| Type | Article in Periodical |
| Magazine / Source | Transfuze a hematologie dnes |
| MU Faculty or unit | |
| Citation | |
| Field | Oncology and hematology |
| Keywords | chimerism; microchimerism; relapse; AML; RQ-PCR |
| Description | The reoccurrence or increase of autologous hematopoiesis after allogeneic stem cell transplantation has been linked with incipient leukemia relapse, however, importance of such emergency regarding microchimerism (chimerism under 1% of autologous cells) remains controversial. We compared conventional PCR of minisatellite, microsatellite, or sex specific regions followed by fragment analysis (FA) with real-time quantitative PCR (RQ-PCR) of insertion/deletion and sex polymorphism. Chimerism values obtained from both analyses were compared with the status of the disease (continuous complete remission, molecular relapse, hematological relapse, HR). Whereas RQ-PCR analysis of microchimerism predicted full HR in 12/13 cases (92%) with median of 34 days (0-322 days), the conventional FA was successful only in 5/13 cases (38%) (median 0 days, interval 0-154 days; p = 0.002). RQ-PCR surpassed FA in 10 cases with median of earlier prediction of relapse of 35 days (interval 6-168 days). Besides this, RQ-PCR detected other 4/6 HR until one year after transplantation, beyond the sensitivity of FA. Further, RQ-PCR examination of peripheral blood in combination with bone marrow confirmed all 9 molecular relapses previously detected due to a specific molecular marker. We conclude, that RQ-PCR is sensitive and reliable method of microchimerism analysis that can predict impending relapse and allows therefore earlier clinical intervention in comparison with another, less sensitive method. |
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