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Quantification of donor and recipient hemopoietic cells by real-time PCR of single nucleotide polymorphisms

A Corrigendum to this article was published on 24 February 2004

Abstract

Analysis of changes in recipient and donor hemopoietic cell origin is extremely useful to monitor the effect of stem cell transplantation (SCT) and sequential adoptive immunotherapy by donor lymphocyte infusions (DLI). We developed a sensitive and accurate method to quantify the percentage of recipient and donor cells by real-time PCR using single nucleotide polymorphisms (SNPs) as markers. Allele-specific PCR of seven SNPs resulted in specific markers for donor or recipient in 97% of HLA-identical sibling pairs. Both, recipient- and donor-derived hemopoietic cells can be simultaneously analyzed in 67% sibling pairs. We expect this can be increased to approximately 99% by developing three additional SNP-PCR. Serial dilution of SNP-positive DNA into either SNP-negative DNA or water revealed a detection limit of 0.1–0.01% depending on the amount of input DNA and start Ct of the used SNP-PCR. Application of our real-time SNP-PCR method for a CML patient treated by allogeneic SCT and DLI demonstrated its feasibility to follow donor T-cell chimerism and early detection of residual and recurrent autologous hemopoiesis in response to treatment. This detailed monitoring of the genetic origin of hemopoietic cells, in particular immune effector cells and target cells after SCT and DLI, may substantially contribute to understanding of the mechanisms that play a role in the success of treatment.

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References

  1. Horowitz MM, Gale RP, Sondel PM, Goldman JM, Kersey J, Kolb HJ et al. Graft-versus-leukemia reactions after bone marrow transplantation. Blood 1990; 75: 555–562.

    CAS  PubMed  Google Scholar 

  2. Butturini A, Gale RP . T-cell depletion in bone marrow transplantation for leukemia: current results and future directions. Bone Marrow Transplant 1988; 3: 185–192.

    CAS  PubMed  Google Scholar 

  3. Gale RP, Horowitz MM, Ash RC, Champlin RE, Goldman JM, Rimm AA et al. Identical-twin bone marrow transplants for leukemia. Ann Intern Med 1994; 120: 646–652.

    Article  CAS  PubMed  Google Scholar 

  4. Slavin S, Nagler A, Naparstek E, Kapelushnik Y, Aker M, Cividalli G et al. Nonmyeloablative stem cell transplantation and cell therapy as an alternative to conventional bone marrow transplantation with lethal cytoreduction for the treatment of malignant and nonmalignant hematologic diseases. Blood 1998; 91: 756–763.

    CAS  PubMed  Google Scholar 

  5. Badros A, Barlogie B, Morris C, Desikan R, Martin SR, Munshi N et al. High response rate in refractory and poor-risk multiple myeloma after allotransplantation using a nonmyeloablative conditioning regimen and donor lymphocyte infusions. Blood 2001; 97: 2574–2579.

    Article  CAS  PubMed  Google Scholar 

  6. Kolb HJ, Holler E . Adoptive immunotherapy with donor lymphocyte transfusions. Curr Opin Oncol 1997; 9: 139–145.

    Article  CAS  PubMed  Google Scholar 

  7. Slavin S . New strategies for bone marrow transplantation. Curr Opin Immunol 2000; 12: 542–551.

    Article  CAS  PubMed  Google Scholar 

  8. Childs R, Clave E, Contentin N, Jayasekera D, Hensel N, Leitman S et al. Engraftment kinetics after nonmyeloablative allogeneic peripheral blood stem cell transplantation: full donor T-cell chimerism precedes alloimmune responses. Blood 1999; 94: 3234–3241.

    CAS  PubMed  Google Scholar 

  9. Childs R, Chernoff A, Contentin N, Bahceci E, Schrump D, Leitman S et al. Regression of metastatic renal-cell carcinoma after nonmyeloablative allogeneic peripheral-blood stem-cell transplantation. N Engl J Med 2000; 343: 750–758.

    Article  CAS  PubMed  Google Scholar 

  10. Schaap N, Schattenberg A, Bär B, Preijers F, van de Wiel-van Kemenade E, de Witte T . Induction of graft-versus-leukemia to prevent relapse after partially lymphocyte-depleted allogeneic bone marrow transplantation by pre-emptive donor leukocyte infusions. Leukemia 2001; 15: 1339–1346.

    Article  CAS  PubMed  Google Scholar 

  11. De Lima M, Bonamino M, Vasconcelos Z, Colares M, Diamond H, Zalcberg I et al. Prophylactic donor lymphocyte infusions after moderately ablative chemotherapy and stem cell transplantation for hematological malignancies: high remission rate among poor prognosis patients at the expense of graft-versus-host disease. Bone Marrow Transplant 2001; 27: 73–78.

    Article  CAS  PubMed  Google Scholar 

  12. Dazzi F, Szydlo RM, Cross NC, Craddock C, Kaeda J, Kanfer E et al. Durability of responses following donor lymphocyte infusions for patients who relapse after allogeneic stem cell transplantation for chronic myeloid leukemia. Blood 2000; 96: 2712–2716.

    CAS  PubMed  Google Scholar 

  13. Dazzi F, Goldman J . Donor lymphocyte infusions. Curr Opin Hematol 1999; 6: 394–399.

    Article  CAS  PubMed  Google Scholar 

  14. Kolb HJ, Schattenberg A, Goldman JM, Hertenstein B, Jacobsen N, Arcese W et al. Graft-versus-leukemia effect of donor lymphocyte transfusions in marrow grafted patients. European Group for Blood and Marrow Transplantation Working Party Chronic Leukemia. Blood 1995; 86: 2041–2050.

    CAS  PubMed  Google Scholar 

  15. Morecki S, Slavin S . Toward amplification of a graft-versus-leukemia effect while minimizing graft-versus-host disease. J Hematother Stem Cell Res 2000; 9: 355–366.

    Article  CAS  PubMed  Google Scholar 

  16. Mackinnon S, Papadopoulos EB, Carabasi MH, Reich L, Collins NH, Boulad F et al. Adoptive immunotherapy evaluating escalating doses of donor leukocytes for relapse of chronic myeloid leukemia after bone marrow transplantation: separation of graft-versus-leukemia responses from graft-versus-host disease. Blood 1995; 86: 1261–1268.

    CAS  PubMed  Google Scholar 

  17. Dazzi F, Szydlo RM, Craddock C, Cross NC, Kaeda J, Chase A et al. Comparison of single-dose and escalating-dose regimens of donor lymphocyte infusion for relapse after allografting for chronic myeloid leukemia. Blood 2000; 95: 67–71.

    CAS  PubMed  Google Scholar 

  18. Slavin S, Naparstek E, Nagler A, Ackerstein A, Samuel S, Kapelushnik J et al. Allogeneic cell therapy with donor peripheral blood cells and recombinant human interleukin-2 to treat leukemia relapse after allogeneic bone marrow transplantation. Blood 1996; 87: 2195–2204.

    CAS  PubMed  Google Scholar 

  19. Carlens S, Remberger M, Aschan J, Ringden O . The role of disease stage in the response to donor lymphocyte infusions as treatment for leukemic relapse. Biol Blood Marrow Transplant 2001; 7: 31–38.

    Article  CAS  PubMed  Google Scholar 

  20. Mackinnon S, Barnett L, Heller G . Polymerase chain reaction is highly predictive of relapse in patients following T-cell-depleted allogeneic bone marrow transplantation for chronic myeloid leukemia. Bone Marrow Transplant 1996; 17: 643–647.

    CAS  PubMed  Google Scholar 

  21. Olavarria E, Kanfer E, Szydlo R, Kaeda J, Rezvani K, Cwynarski K et al. Early detection of BCR-ABL transcripts by quantitative reverse transcriptase-polymerase chain reaction predicts outcome after allogeneic stem cell transplantation for chronic myeloid leukemia. Blood 2001; 97: 1560–1565.

    Article  CAS  PubMed  Google Scholar 

  22. Serrano J, Roman J, Sanchez J, Jimenez A, Castillejo JA, Herrera C et al. Molecular analysis of lineage-specific chimerism and minimal residual disease by RT-PCR of p210(BCR-ABL) and p190(BCR-ABL) after allogeneic bone marrow transplantation for chronic myeloid leukemia: increasing mixed myeloid chimerism and p190(BCR-ABL) detection precede cytogenetic relapse. Blood 2000; 95: 2659–2665.

    CAS  PubMed  Google Scholar 

  23. Elmaagacli AH, Beelen DW, Kroll M, Trzensky S, Stein C, Schaefer UW . Detection of CBFbeta/MYH11 fusion transcripts in patients with inv(16) acute myeloid leukemia after allogeneic bone marrow or peripheral blood progenitor cell transplantation. Bone Marrow Transplant 1998; 21: 159–166.

    Article  CAS  PubMed  Google Scholar 

  24. Tobal K, Newton J, Macheta M, Chang J, Morgenstern G, Evans PA et al. Molecular quantitation of minimal residual disease in acute myeloid leukemia with t(8;21) can identify patients in durable remission and predict clinical relapse. Blood 2000; 95: 815–819.

    CAS  PubMed  Google Scholar 

  25. Lion T, Daxberger H, Dubovsky J, Filipcik P, Fritsch G, Printz D et al. Analysis of chimerism within specific leukocyte subsets for detection of residual or recurrent leukemia in pediatric patients after allogeneic stem cell transplantation. Leukemia 2001; 15: 307–310.

    Article  CAS  PubMed  Google Scholar 

  26. Bader P, Stoll K, Huber S, Geiselhart A, Handgretinger R, Niemeyer C et al. Characterization of lineage-specific chimaerism in patients with acute leukaemia and myelodysplastic syndrome after allogeneic stem cell transplantation before and after relapse. Br J Haematol 2000; 108: 761–768.

    Article  CAS  PubMed  Google Scholar 

  27. Bader P, Klingebiel T, Schaudt A, Theurer-Mainka U, Handgretinger R, Lang P et al. Prevention of relapse in pediatric patients with acute leukemias and MDS after allogeneic SCT by early immunotherapy initiated on the basis of increasing mixed chimerism: a single center experience of 12 children. Leukemia 1999; 13: 2079–2086.

    Article  CAS  PubMed  Google Scholar 

  28. Schattenberg A, Schaap N, van de Wiel-van Kemenade E, Bär B, Preijers F, Van der Maazen R et al. In relapsed patients after lymphocyte depleted bone marrow transplantation the percentage of donor T lymphocytes correlates well with the outcome of donor leukocyte infusion. Leukemia Lymphoma 1999; 32: 317–325.

    Article  CAS  PubMed  Google Scholar 

  29. Blazar BR, Lees CJ, Martin PJ, Noelle RJ, Kwon B, Murphy W et al. Host T cells resist graft-versus-host disease mediated by donor leukocyte infusions. J Immunol 2000; 165: 4901–4909.

    Article  CAS  PubMed  Google Scholar 

  30. Johnson BD, Becker EE, LaBelle JL, Truitt RL . Role of immunoregulatory donor T cells in suppression of graft-versus-host disease following donor leukocyte infusion therapy. J Immunol 1999; 163: 6479–6487.

    CAS  PubMed  Google Scholar 

  31. Dubovsky J, Daxberger H, Fritsch G, Printz D, Peters C, Matthes S et al. Kinetics of chimerism during the early post-transplant period in pediatric patients with malignant and non-malignant hematologic disorders: implications for timely detection of engraftment, graft failure and rejection. Leukemia 1999; 13: 2060–2069.

    Article  CAS  Google Scholar 

  32. Wang DG, Fan JB, Siao CJ, Berno A, Young P, Sapolsky R et al. Large-scale identification, mapping, and genotyping of single-nucleotide polymorphisms in the human genome. Science 1998; 280: 1077–1082.

    Article  CAS  PubMed  Google Scholar 

  33. Nichols WC, Antin JH, Lunetta KL, Terry VH, Hertel CE, Wheatley MA et al. Polymorphism of adhesion molecule CD31 is not a significant risk factor for graft-versus-host disease. Blood 1996; 88: 4429–4434.

    CAS  PubMed  Google Scholar 

  34. Behar E, Chao NJ, Hiraki DD, Krishnaswamy S, Brown BW, Zehnder JL et al. Polymorphism of adhesion molecule CD31 and its role in acute graft-versus-host disease. N Engl J Med 1996; 334: 286–291.

    Article  CAS  PubMed  Google Scholar 

  35. Vora DK, Rosenbloom CL, Beaudet AL, Cottingham RW . Polymorphisms and linkage analysis for ICAM-1 and the selectin gene cluster. Genomics 1994; 21: 473–477.

    Article  CAS  PubMed  Google Scholar 

  36. Mycko MP, Kwinkowski M, Tronczynska E, Szymanska B, Selmaj KW . Multiple sclerosis: the increased frequency of the ICAM-1 exon 6 gene point mutation genetic type K469. Ann Neurol 1998; 44: 70–75.

    Article  CAS  PubMed  Google Scholar 

  37. Wilke M, Pool J, den Haan JM, Goulmy E . Genomic identification of the minor histocompatibility antigen HA-1 locus by allele-specific PCR. Tissue Antigens 1998; 52: 312–317.

    Article  CAS  PubMed  Google Scholar 

  38. Tseng LH, Lin MT, Martin PJ, Pei J, Smith AG, Hansen JA . Definition of the gene encoding the minor histocompatibility antigen HA-1 and typing for HA-1 from genomic DNA. Tissue Antigens 1998; 52: 305–311.

    Article  CAS  PubMed  Google Scholar 

  39. Ito E, Yanagisawa Y, Iwahashi Y, Suzuki Y, Nagasaki H, Akiyama Y et al. A core promoter and a frequent single-nucleotide polymorphism of the mismatch repair gene hMLH1. Biochem Biophys Res Commun 1999; 256: 488–494.

    Article  CAS  PubMed  Google Scholar 

  40. Hansen T, Echwald SM, Hansen L, Moller AM, Almind K, Clausen JO et al. Decreased tolbutamide-stimulated insulin secretion in healthy subjects with sequence variants in the high-affinity sulfonylurea receptor gene. Diabetes 1998; 47: 598–605.

    Article  CAS  PubMed  Google Scholar 

  41. Taillon-Miller P, Piernot EE, Kwok PY . Efficient approach to unique single-nucleotide polymorphism discovery. Genome Res 1999; 9: 499–505.

    CAS  PubMed  PubMed Central  Google Scholar 

  42. Higuchi R, Fockler C, Dollinger G, Watson R . Kinetic PCR analysis, real-time monitoring of DNA amplification reactions. Biotechnology 1993; 11: 1026–1030.

    CAS  PubMed  Google Scholar 

  43. Livak KJ, Flood SJ, Marmaro J, Giusti W, Deetz K . Oligonucleotides with fluorescent dyes at opposite ends provide a quenched probe system useful for detecting PCR product and nucleic acid hybridization. PCR Methods Appl 1995; 4: 357–562.

    Article  CAS  PubMed  Google Scholar 

  44. Holland PM, Abramson RD, Watson R, Gelfand DH . Detection of specific polymerase chain reaction products by utilizing the 5′–3′ exonuclease activity of Thermus aquaticus DNA polymerase. Proc Natl Acad Sci USA 1991; 88: 7276–7280.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Mandigers CMPW, Meijerink JPP, Raemaekers JMM, Schattenberg AVMB, Mensink EJBM . Graft-versus-lymphoma effect of donor leucocyte infusion shown by real-time quantitative PCR analysis of t(14;18). Lancet 1998; 352: 1522–1523.

    Article  CAS  PubMed  Google Scholar 

  46. Schaap N, Schattenberg A, Mensink E, Preijers F, Hillegers M, Knops R et al. Long-term follow-up of persisting mixed chimerism after partially T-cell-depleted allogeneic stem cell transplantation. Leukemia 2002; 16: 13–21.

    Article  CAS  PubMed  Google Scholar 

  47. Mackinnon S, Barnett L, Heller G, O'Reilly RJ . Minimal residual disease is more common in patients who have mixed T-cell chimerism after bone marrow transplantation for chronic myelogenous leukemia. Blood 1994; 83: 3409–3416.

    CAS  PubMed  Google Scholar 

  48. Mattsson J, Uzunel M, Remberger M, Ringden O . T-cell mixed chimerism is significantly correlated to a decreased risk of acute graft-versus-host disease after allogeneic stem cell transplantation. Transplantation 2001; 71: 433–439.

    Article  CAS  PubMed  Google Scholar 

  49. Slavin S . Immunotherapy of cancer with alloreactive lymphocytes. N Engl J Med 2000; 343: 802–803.

    Article  CAS  PubMed  Google Scholar 

  50. Roman J, Alvarez MA, Torres A . Molecular basis for therapeutic decisions in chronic myeloid leukemia patients after allogeneic bone marrow transplantation. Haematologica 2000; 85: 1072–1082.

    CAS  PubMed  Google Scholar 

  51. Exner BG, Acholonu I, Ildstad ST . Hematopoietic chimerism, tolerance induction and graft-versus-host disease: considerations for composite tissue transfer. Transplant Proc 1998; 6: 2718–2720.

    Article  Google Scholar 

  52. Fehse B, Chukhlovin A, Kuhlcke K, Marinetz O, Vorwig O, Renges H et al. Real-time quantitative y chromosome-specific pcr (qycs-pcr) for monitoring hematopoietic chimerism after sex-mismatched allogeneic stem cell transplantation. J Hematother Stem Cell Res 2001; 10: 419–425.

    Article  CAS  PubMed  Google Scholar 

  53. Luhm RA, Bellissimo DB, Uzgiris AJ, Drobyski WR, Hessner MJ . Quantitative evaluation of post-bone marrow transplant engraftment status using fluorescent-labeled variable number of tandem repeats. Mol Diagn 2000; 5: 129–138.

    Article  CAS  PubMed  Google Scholar 

  54. Lion T . Chimerism testing after allogeneic stem cell transplantation: importance of timing and optimal technique for testing in different clinical–biological situations. Leukemia 2001; 15: 292.

    Article  PubMed  Google Scholar 

  55. Buno I, Wyatt WA, Zinsmeister AR, Dietz-Band J, Silver RT, Dewald GW . A special fluorescent in situ hybridization technique to study peripheral blood and assess the effectiveness of interferon therapy in chronic myeloid leukemia. Blood 1998; 92: 2315–2321.

    CAS  PubMed  Google Scholar 

  56. Thiede C, Bornhauser M, Oelschlagel U, Brendel C, Leo R, Daxberger H et al. Sequential monitoring of chimerism and detection of minimal residual disease after allogeneic blood stem cell transplantation (BSCT) using multiplex PCR amplification of short tandem repeat-markers. Leukemia 2001; 15: 293–302.

    Article  CAS  PubMed  Google Scholar 

  57. Kruglyak L . The use of a genetic map of biallelic markers in linkage studies. Nat Genet 1997; 17: 21–24.

    Article  CAS  PubMed  Google Scholar 

  58. Díez-Martín JL, Llamas P, Gosálvez J, López-Fernández C, Polo N, De La Fuente MS et al. Conventional cytogenetics and FISH evaluation of chimaerism after sex-mismatched bone marrow transplantation (BMT) and donor leucocyte infusion (DLI). Haematologica 1998; 83: 408–415.

    PubMed  Google Scholar 

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Acknowledgements

We are indebted to Marieke Overdijk, Paulien Polderman, Adrian van der Heijden, and Rob Woestenenk for screening recipient and donor DNA for SNPs. We thank Dr Joop Jansen for critically reading the manuscript. This work was supported by the Dutch Cancer Foundation Grant KUN 96-1363.

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Maas, F., Schaap, N., Kolen, S. et al. Quantification of donor and recipient hemopoietic cells by real-time PCR of single nucleotide polymorphisms. Leukemia 17, 621–629 (2003). https://doi.org/10.1038/sj.leu.2402856

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