骨髓CD34+分子嵌合作为急性髓系白血病患者异基因干细胞移植后复发的早期预测指标。
Bone marrow CD34+ molecular chimerism as an early predictor of relapse after allogeneic stem cell transplantation in patients with acute myeloid leukemia.
作者信息
Malagola Michele, Polverelli Nicola, Beghin Alessandra, Bolda Federica, Comini Marta, Farina Mirko, Morello Enrico, Radici Vera, Accorsi Buttini Eugenia, Bernardi Simona, Re Federica, Leoni Alessandro, Bonometti Davide, Brugnoni Duilio, Lanfranchi Arnalda, Russo Domenico
机构信息
Blood Diseases and Cell Therapies unit, Bone Marrow Transplant Unit, "ASST-Spedali Civili" Hospital of Brescia, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Stem Cell Laboratory, Section of Hematology and Blood Coagulation, Clinical Chemistry Laboratory, Diagnostics Department, ASST Spedali Civili of Brescia, Brescia, Italy.
出版信息
Front Oncol. 2023 Mar 6;13:1133418. doi: 10.3389/fonc.2023.1133418. eCollection 2023.
BACKGROUND
Minimal residual disease (MRD) monitoring is an important tool to optimally address post-transplant management of acute myeloid leukemia (AML) patients.
METHODS
We retrospectively analyzed the impact of bone marrow CD34+ molecular chimerism and on the outcome of a consecutive series of 168 AML patients submitted to allogeneic stem cell transplantation.
RESULTS
The cumulative incidence of relapse (CIR) was significantly lower in patients with donor chimerism on CD34+ cells ≥ 97.5% and < 213 copies/ABL x 10^4 both at 1 month (p=0.008 and p<0.001) and at 3 month (p<0.001 for both). By combining chimerism and at 3 month, 13 patients with chimerism < 97.5% or > 213 showed intermediate prognosis. 12 of these patients fell in this category because of molecular chimerism < 97.5% at a time-point in which was < 213.
CONCLUSIONS
Our results confirm that lineage-specific molecular chimerism and after allo-SCT (1 and 3 month) are useful MRD markers. When considered together at 3 month, CD34+ molecular chimerism could represent an earlier predictor of relapse compared to . Further studies are necessary to confirm this preliminary observation.
背景
微小残留病（MRD）监测是优化急性髓系白血病（AML）患者移植后管理的重要工具。
方法
我们回顾性分析了168例接受异基因干细胞移植的AML患者的连续系列中，骨髓CD34 +分子嵌合率以及[此处原文缺失部分内容]对预后的影响。
结果
在1个月时（p = 0.008和p < 0.001）以及3个月时（两者均p < 0.001），CD34 +细胞上供体嵌合率≥97.5%且[此处原文缺失部分内容]< 213拷贝/ABL x 10^4的患者复发累积发生率（CIR）显著更低。通过在3个月时结合嵌合率和[此处原文缺失部分内容]，13例嵌合率< 97.5%或[此处原文缺失部分内容]> 213的患者显示出中等预后。其中12例患者属于这一类别是因为在[此处原文缺失部分内容]< 213的某个时间点分子嵌合率< 97.5%。
结论
我们的结果证实，异基因造血干细胞移植后（1个月和3个月）的谱系特异性分子嵌合率和[此处原文缺失部分内容]是有用的MRD标志物。在3个月时综合考虑，与[此处原文缺失部分内容]相比，CD34 +分子嵌合率可能是复发的更早预测指标。需要进一步研究来证实这一初步观察结果。
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