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Abstract
Chimerism testing permits early prediction and documentation of successful engraftment, and also facilitates detection of impending graft rejection. In this study, we serially monitored chimerism status by short tandem repeat-based PCR in nucleated cells (NC), T cells and natural killer (NK) cells after myeloablative allogeneic stem cell transplantation (SCT). Four patients with myeloid malignancies showed discrepant chimerism results among those three fractions. Three patients had mixed chimerism (MC) of donor/host T cells at a time point around the onset of chronic graft-versus-host disease (GVHD). In two patients with disease relapse, MC of NK cells preceded a morphological relapse or NK cells showed a higher percentage of patient cells compared to NC. Therefore, our study shows that chimerism analysis in lineage-specific cells might be useful in predicting clinical outcome after allogeneic SCT in certain patients.
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Fig. 1.
Schematic presentation of serial lineage-specific chimerism data in four patients. (A) 46.2% MC of T cells on day 371 and 100% patient cells of NK cells and 64.8% MC of NC on day 553, respectively (arrows). (B) MC of T cells alone on day 291 (arrow). (C) On day 189, only NK cells showed 3.4% MC (arrow). (D) MC of T cells showing 29.0%, 19.5%, and 18.5% of patient cells on day 32, 93, and 119, respectively. NC showed 7.2% of patient cells briefly at day 32 (arrows).
Abbreviations: MC, mixed chimerism; NC, nucleated cells; NK, natural killer.
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