Guz Katarzyna, Nasiłowska Barbara, Tomaszewska Agnieszka, Orzińska Agnieszka, Smolarczyk-Wodzyńska Justyna, Krzemienowska Magdalen, Hałaburda Kazimierz, Przybylski Maciej, Jędrzejczak Wiesław Wiktor, Mariańska Bożena, Brojer Ewa
Department of of Immunohematology and Transfusion Medicine, Institute of Hematology and Transfusion Medicine, Warsaw, Poland.
Department of Haemopoietic Stem Cell Transplantation, Institute of Hematology and Transfusion Medicine, Warsaw, Poland.
Ann Transplant. 2015 Dec 3;20:720-8. doi: 10.12659/aot.894621.
Graft-versus-host-disease (GvHD) is the major cause of morbidity and mortality after stem cell transplantation. The development of early prediction methods is therefore of importance. Our aim was to analyze the usefulness of early donor chimerism monitoring after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in T cells and in CD4+ and CD8+ (lineage chimerism) for GvHD prediction.
Chimerism was analyzed in 76 consecutive adult patients using RQ-PCR TaqMan technology on DNA extracted from Pan T, CD4+, and CD8+ cell subsets on Day 5, 10, 15 and 30 after allo-HSCT.
The threshold of chimerism predictive for GvHD was the same for all tested cell subsets. In acute myeloid leukemia (AML) patients treated with myeloablative conditioning (MAC), the threshold predictive for acute graft versus host disease was 95% and 99% for Day 10 and Day 15, respectively. In patients treated with reduced intensity conditioning (RIC), the threshold predictive for chronic graft versus host disease was 98% on Day 10. The differences were statistically significant.
Chimerism analysis in T cell subsets by RQ-PCR on Day 10 and Day 15 after transplantation is useful for prediction of aGvHD (AML patients after MAC) and cGvHD (patients after RIC). However, there was no difference in the results between chimerism in the T cell subsets. Our RQ-PCR protocol was highly sensitive and proved effective for analysis of lineage chimerism.
移植物抗宿主病（GvHD）是干细胞移植后发病和死亡的主要原因。因此，开发早期预测方法至关重要。我们的目的是分析异基因造血干细胞移植（allo-HSCT）后早期供体嵌合体监测在T细胞以及CD4+和CD8+（谱系嵌合体）中对GvHD预测的有用性。
对76例连续的成年患者进行嵌合体分析，在allo-HSCT后的第5、10、15和30天，使用RQ-PCR TaqMan技术对从全T、CD4+和CD8+细胞亚群中提取的DNA进行分析。
所有测试细胞亚群中预测GvHD的嵌合体阈值相同。在接受清髓性预处理（MAC）的急性髓系白血病（AML）患者中，预测急性移植物抗宿主病的阈值在第10天和第15天分别为95%和99%。在接受减低强度预处理（RIC）的患者中，预测慢性移植物抗宿主病的阈值在第10天为98%。差异具有统计学意义。
移植后第10天和第15天通过RQ-PCR对T细胞亚群进行嵌合体分析，有助于预测急性移植物抗宿主病（MAC后的AML患者）和慢性移植物抗宿主病（RIC后的患者）。然而，T细胞亚群的嵌合体结果之间没有差异。我们的RQ-PCR方案高度敏感，证明对谱系嵌合体分析有效。
