Charité University School of Medicine, Department of Hematology and Oncology, Berlin, Germany
Allogenic hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for various hematological disorders. Different molecular genetics methods are useful to monitor engraftment, relapse of the underlying disease, rejection of the graft, and minimal residual disease. Cytogenetic investigations, fluorescence in situ hybridization, PCR on chromosome abnormalities, lymphocyte-receptor gene rearrangement, and chimerism analysis are widely employed, although they are characterized by different sensitivity. Quantitative analysis of chimerism after HSCT is an important method for monitoring engraftment and allows discrimination between graft failure and relapse. This method appears to be adequate after reduced intensity conditioning (RIC) HSCT, when graft versus leukemia effect plays an important role in leukemia eradication. The use of lineage-specific chimerism analysis makes chimerism study more informative. Stable long-term complete chimerism correlates with complete hematological remission. Mixed chimerism is usually associated with relapse or graft failure. Prolonged mixed chimerism is a phenomenon in some patients after RIC with chronic lymphoproliferative disorders. This may be important to understand graft versus leukemia effect in such patients. Serial chimerism analysis is a suitable tool to evaluate efficacy of transplantation and early identification of relapse.
Keywords: allogenic hematopoietic stem cell transplantation, chimerism.
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