Abstract
Relapse is a major complication of acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (SCT). The objective of our study was to evaluate chimerism monitoring on the CD3-negative mononuclear cells by RQ-PCR to predict relapse of patients allografted for AML and to compare its performance with WT1 quantification. A cohort of 100 patients undergoing allogenic SCT for AML was retrospectively analyzed in a single institution. Patients without complete chimerism, defined as less than 0.01% of recipient’s DNA in CD3-negative cells, had a significantly higher risk of relapse and a lower overall survival (p < 0.001). An increase in the percentage of recipient DNA in CD3-negative cells was associated with an increased risk of relapse (p < 0.001) but not with overall survival. Comparable performances between monitoring of CD3-negative cell chimerism and WT1 expression to predict relapse was observed up to more than 90 days before hematological relapse, with sensitivity of 82% and 78%, respectively, and specificity of 100% for both approaches. Quantitative specific chimerism of the CD3-negative mononuclear fraction, enriched in blastic cells, is a new and powerful tool for monitoring measurable residual disease and could be used for AML patients without available molecular markers.
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Acknowledgements
This work was realized in the context of (i) the LabEX IGO program supported by the National Research Agency via the investment of the future program ANR-11-LABX-0016-01 and of (ii) the SIRIC ILIAD program supported by the French National Cancer Institute national (INCa), the Ministry of Health and the Institute for Health and Medical Research (Inserm) (contract INCa-DGOS-Inserm_12558). The authors would like to thank the patients who participated in this study, and the technicians who participated in biological collection and experimental procedures.
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Bouvier, A., Riou, J., Thépot, S. et al. Quantitative chimerism in CD3-negative mononuclear cells predicts prognosis in acute myeloid leukemia patients after hematopoietic stem cell transplantation. Leukemia 34, 1342–1353 (2020). https://doi.org/10.1038/s41375-019-0624-4
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DOI: https://doi.org/10.1038/s41375-019-0624-4