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Miura S, Ueda K, Minakawa K, Nollet KE, Ikeda K. Prospects and Potential for Chimerism Analysis after Allogeneic Hematopoietic Stem Cell Transplantation. Cells 2024; 13:993. [PMID: 38891125 PMCID: PMC11172215 DOI: 10.3390/cells13110993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 06/21/2024] Open
Abstract
Chimerism analysis after allogeneic hematopoietic stem cell transplantation serves to confirm engraftment, indicate relapse of hematologic malignancy, and attribute graft failure to either immune rejection or poor graft function. Short tandem repeat PCR (STR-PCR) is the prevailing method, followed by quantitative real-time PCR (qPCR), with detection limits of 1-5% and 0.1%, respectively. Chimerism assays using digital PCR or next-generation sequencing, both of which are more sensitive than STR-PCR, are increasingly used. Stable mixed chimerism is usually not associated with poor outcomes in non-malignant diseases, but recipient chimerism may foretell relapse of hematologic malignancies, so higher detection sensitivity may be beneficial in such cases. Thus, the need for and the type of intervention, e.g., immunosuppression regimen, donor lymphocyte infusion, and/or salvage second transplantation, should be guided by donor chimerism in the context of the feature and/or residual malignant cells of the disease to be treated.
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Affiliation(s)
- Saori Miura
- Department of Clinical Laboratory Sciences, Fukushima Medical University School of Health Sciences, Fukushima 960-8516, Japan
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Koki Ueda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Keiji Minakawa
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Kenneth E. Nollet
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Kazuhiko Ikeda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
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2
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Brow D, Shike H, Kendrick J, Pettersson L, Mineishi S, Claxton DF, Wirk B, Cioccio J, Greiner RJ, Viswanatha D, Kharfan-Dabaja MA, Li Z, Tyler J, Elrefaei M. Assessment of chimerism by next generation sequencing: A comparison to STR/qPCR methods. Hum Immunol 2024; 85:110794. [PMID: 38553384 DOI: 10.1016/j.humimm.2024.110794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 02/20/2024] [Accepted: 03/25/2024] [Indexed: 06/04/2024]
Abstract
Chimerism analysis is used to evaluate patients after allogeneic hematopoietic stem cell transplant (allo-HSCT) for engraftment and minimal measurable residual disease (MRD) monitoring. A combination of short-tandem repeat (STR) and quantitative polymerase chain reaction (qPCR) was required to achieve both sensitivity and accuracy in the patients with various chimerism statuses. In this study, an insertion/deletion-based multiplex chimerism assay by next generation sequencing (NGS) was evaluated using 5 simulated unrelated donor-recipient combinations from 10 volunteers. Median number of informative markers detected was 8 (range = 5 - 11). The limit of quantitation (LoQ) was determined to be 0.1 % recipient. Assay sample number/batch was 10-20 and total assay time was 19-31 h (manual labor = 2.1 h). Additionally, 50 peripheral blood samples from 5 allo-HSCT recipients (related: N = 4; unrelated: N = 1) were tested by NGS and STR/qPCR. Median number of informative markers detected was 7 (range = 4 - 12). Results from both assays demonstrated a strong correlation (Y = 0.9875X + 0.333; R2 = 0.9852), no significant assay bias (difference mean - 0.08), and 100 % concordant detection of percent recipient increase ≥ 0.1 % (indicator of increased relapse risk). NGS-based chimerism assay can support all allo-HSCT for engraftment and MRD monitoring and simplify clinical laboratory workflow compared to STR/qPCR.
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Affiliation(s)
- Darren Brow
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA
| | - Hiroko Shike
- Penn State Hershey Medical Center, Pathology, Hershey, PA, USA
| | - Jasmine Kendrick
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Shin Mineishi
- Penn State Hershey Medical Center, Hematology Oncology, Hershey, PA, USA
| | - David F Claxton
- Penn State Hershey Medical Center, Hematology Oncology, Hershey, PA, USA
| | - Baldeep Wirk
- Penn State Hershey Medical Center, Hematology Oncology, Hershey, PA, USA
| | - Joseph Cioccio
- Penn State Hershey Medical Center, Hematology Oncology, Hershey, PA, USA
| | - Robert J Greiner
- Penn State Hershey Medical Center, Pediatric Hematology Oncology, Hershey, PA, USA
| | - David Viswanatha
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Mohamed A Kharfan-Dabaja
- Division of Hematology Oncology and Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Zhuo Li
- Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA
| | - Jennifer Tyler
- Penn State Hershey Medical Center, Pathology, Hershey, PA, USA
| | - Mohamed Elrefaei
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA.
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3
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Donati F, Natalucci A, Concetti L, de la Torre X, Botrè F. A SNP-based genotyping strategy to detect the abuse of homologous blood transfusion from dried blood spots. Drug Test Anal 2024. [PMID: 38291987 DOI: 10.1002/dta.3650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/28/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Abstract
We performed genotyping analysis of human biallelic polymorphisms (single nucleotide polymorphisms) for the detection of homologous blood transfusion in sports doping. DNA was extracted from dried blood spots and quantified real-time fast PCR. The method was proven to allow the detection of transfusions up to a donor percentage of 1%, with a significant improvement in terms of sensitivity with respect to both the reference cytofluorimetric method and a previously proposed strategy based on the DNA STR-based strategy.
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Affiliation(s)
- Francesco Donati
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Alice Natalucci
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Livia Concetti
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Xavier de la Torre
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Francesco Botrè
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
- REDs-Research and Expertise in anti-Doping sciences, ISSUL-Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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4
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Arnold PY. Review: HLA loss and detection in the setting of relapse from HLA-mismatched hematopoietic cell transplant. Hum Immunol 2022; 83:712-720. [DOI: 10.1016/j.humimm.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/09/2022] [Accepted: 03/02/2022] [Indexed: 01/25/2023]
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5
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Delie A, Verlinden A, Beel K, Deeren D, Mazure D, Baron F, Breems D, De Becker A, Graux C, Lewalle P, Maertens J, Poire X, Schoemans H, Selleslag D, Van Obbergh F, Kerre T. Use of chimerism analysis after allogeneic stem cell transplantation: Belgian guidelines and review of the current literature. Acta Clin Belg 2021; 76:500-508. [PMID: 32362204 DOI: 10.1080/17843286.2020.1754635] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative treatment option in both adult and pediatric patients with malignant and non-malignant hematological diseases. Chimerism analysis, which determines the donor or recipient origin of hematopoietic cells in HSCT recipients, is an essential aspect of post-HSCT follow-up.Objectives: To review the current literature and develop Belgian consensus guidelines for the use of chimerism analysis in the standard of care after allogeneic HSCT.Methods: Non-systematic review of the literature in consultancy with the members of the BHS transplantation committee.Results: Clinical application with regards to prediction of graft failure or relapse as well as cell source are reviewed. A consensus guideline on the use of chimerism analysis after HSCT is presented.Conclusion: Monitoring of the dynamics or kinetics of a patient's chimerism status by serial analysis at fixed time points, as well as on suspicion of relapse or graft failure, is needed to monitor engraftment levels, as well as disease control and possible relapse.
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Affiliation(s)
- Anke Delie
- Department of Hematology, University Hospital, Ghent University, Ghent, Belgium
| | - Anke Verlinden
- Department of Hematology, University Hospital, University of Antwerp, Antwerp, Belgium
| | - Karolien Beel
- Department of Hematology, Ziekenhuis Netwerk, Antwerpen, Belgium
| | - Dries Deeren
- Department of Hematology, AZ Delta, Roeselare, Belgium
| | - Dominiek Mazure
- Department of Hematology, University Hospital, Ghent University, Ghent, Belgium
| | - Frédéric Baron
- Department of Hematology, University Hospital, University of Liège, Liège, Belgium
| | - Dimitri Breems
- Department of Hematology, Ziekenhuis Netwerk, Antwerpen, Belgium
| | - Ann De Becker
- Department of Hematology, University Hospital, Vrije Universiteit Brussel, Brussels, Belgium
| | - Carlos Graux
- Department of Hematology, University Hospital Namur, Université Catholique de Louvain, Belgium
| | - Philippe Lewalle
- Department of Hematology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Johan Maertens
- Department of Hematology, University Hospital, KU Leuven, Leuven, Belgium
| | - Xavier Poire
- Department of Hematology, University Hospital Saint Luc, Univeristé Catholique de Louvain, Brussels, Belgium
| | - Helene Schoemans
- Department of Hematology, University Hospital, KU Leuven, Leuven, Belgium
| | | | | | - Tessa Kerre
- Department of Hematology, University Hospital, Ghent University, Ghent, Belgium
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6
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Tozzo P, Delicati A, Zambello R, Caenazzo L. Chimerism Monitoring Techniques after Hematopoietic Stem Cell Transplantation: An Overview of the Last 15 Years of Innovations. Diagnostics (Basel) 2021; 11:diagnostics11040621. [PMID: 33808342 PMCID: PMC8065704 DOI: 10.3390/diagnostics11040621] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/22/2021] [Accepted: 03/29/2021] [Indexed: 01/14/2023] Open
Abstract
Chimerism analysis is a well-established method for monitoring the state of hematopoietic stem cell transplantation (HSCT) over time by analyzing peripheral blood or bone marrow samples of the recipient in several malignant and non-malignant hematologic diseases. From a clinical point of view, a continuous monitoring is fundamental for an effective early therapeutic intervention. This paper provides a comparative overview of the main molecular biology techniques which can be used to study chimerism after bone marrow transplantation, focusing on their advantages and disadvantages. According to the examined literature, short tandem repeats (STR) analysis through simple PCR coupled with capillary electrophoresis (STR-PCR) is the most powerful method which guarantees a high power of differentiation between different individuals. However, other methods such as real-time quantitative PCR (qPCR), digital PCR (dPCR), and next-generation sequencing (NGS) technology were developed to overcome the technical limits of STR-PCR. In particular, these other techniques guarantee a higher sensitivity, which allows for the detection of chimerism at an earlier stage, hence expanding the window for therapeutic intervention. After a comparative evaluation of the various techniques, it seems clear that STR-PCR still remains the gold standard option for chimerism study, even if it is likely that both dPCR and NGS could supplement or even replace the common methods of STR analysis.
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Affiliation(s)
- Pamela Tozzo
- Department of Molecular Medicine, Laboratory of Forensic Genetics, University of Padova, 35121 Padova, Italy; (A.D.); (L.C.)
- Correspondence: ; Tel.: +39-049-827-2235
| | - Arianna Delicati
- Department of Molecular Medicine, Laboratory of Forensic Genetics, University of Padova, 35121 Padova, Italy; (A.D.); (L.C.)
| | - Renato Zambello
- Department of Medicine (DIMED), Hematology and Clinical Immunology Section, Padova University School of Medicine, 35121 Padova, Italy;
| | - Luciana Caenazzo
- Department of Molecular Medicine, Laboratory of Forensic Genetics, University of Padova, 35121 Padova, Italy; (A.D.); (L.C.)
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Navarro-Bailón A, Carbonell D, Escudero A, Chicano M, Muñiz P, Suárez-González J, Bailén R, Oarbeascoa G, Kwon M, Díez-Martín JL, Martínez-Laperche C, Buño I. Short Tandem Repeats (STRs) as Biomarkers for the Quantitative Follow-Up of Chimerism after Stem Cell Transplantation: Methodological Considerations and Clinical Application. Genes (Basel) 2020; 11:genes11090993. [PMID: 32854376 PMCID: PMC7565503 DOI: 10.3390/genes11090993] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/19/2020] [Accepted: 08/23/2020] [Indexed: 01/06/2023] Open
Abstract
Chimerism refers to the relative proportion of donor and recipient DNA after hematopoietic stem cell transplantation (HSCT) and its quantitative follow-up is of great clinical utility in this setting. PCR of short tandem repeats (STR-PCR) constitutes the gold standard method for chimerism quantification, although more sensitive PCR techniques (such as qPCR) have recently arisen. We compared the sensitivity and the quantification capacity of both techniques in patient samples and artificial mixtures and demonstrated adequate performance of both methods, with higher sensitivity of qPCR and better quantification skills of STR-PCR. By qPCR, we then prospectively followed up 57 patients that were in complete chimerism (CC) by STR-PCR. Twenty-seven patients (59%) showed 0.1–1% recipient DNA in the bone marrow. Only 4 patients presented 0.1–1% recipient DNA in peripheral blood (PB), and one of them relapsed. Finally, by qPCR, we retrospectively studied the last sample that showed CC by STR-PCR prior to relapse in 8 relapsed patients. At a median of 59 days prior to relapse, six patients presented mixed chimerism by qPCR in PB. Since both approaches have complementary characteristics, we conclude that different techniques should be applied in different clinical settings and therefore propose a methodological algorithm for chimerism follow-up after HSCT.
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Affiliation(s)
- Almudena Navarro-Bailón
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
| | - Diego Carbonell
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - Asunción Escudero
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
| | - María Chicano
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - Paula Muñiz
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - Julia Suárez-González
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
- Genomics Unit, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Rebeca Bailén
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - Gillen Oarbeascoa
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - Mi Kwon
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - José Luis Díez-Martín
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
- Department of Medicine, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Carolina Martínez-Laperche
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
- Genomics Unit, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Ismael Buño
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
- Genomics Unit, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Department of Cell Biology, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Correspondence: ; Tel.: +91-5868775
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8
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Nadvornikova S, Leontovycova M, Pegova K, Hrabakova P, Prerovska R, Cechova H. Multiplex real-time quantitative polymerase chain reaction assay for rapid and sensitive detection of hematopoietic chimerism. HLA 2019; 92:215-223. [PMID: 30129247 DOI: 10.1111/tan.13383] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/20/2018] [Accepted: 08/16/2018] [Indexed: 01/28/2023]
Abstract
The increase of mixed chimerism (MC) after allogeneic hematopoietic stem cell transplantation has been associated with a high risk of relapse. A variety of techniques that use polymorphic markers have been established to survey hematopoietic chimerism status. The highest sensitivity is achieved using real-time quantitative polymerase chain reaction (RQ-PCR) analysis of insertion/deletion polymorphism, which allows the detection of disease recurrence and subsequently the earlier initiation of therapeutic intervention. The purpose of this study is the evaluation of multiplex RQ-PCR for MC assessment (six biallelic genetic systems and Y-specific locus), allowing the amplification and detection of target gene of interest and glyceraldehyde-3-phosphate dehydrogenase reference housekeeping gene in a single microtube. With optimized amounts of primers and probe, the quantification of target DNA was shown to be linear throughout the tested range (100%-0.05%). The efficiencies of multiplex RQ-PCR were in a range of 0.89 to 1.07. The sensitivity of individual systems ranged 0.02% to 0.04% with an average of 0.034%. A high degree of linear correlation between the chimerism results obtained by multiplex RQ-PCR vs singleplex RQ-PCR was observed (P < 0.0001, Spearman's coefficient = 0.9927), while correlation between multiplex RQ-PCR vs short tandem repeat analysis was also statistically significant (P < 0.0001, Spearman's coefficient = 0.9769). This new multiplex RQ-PCR assay is a quick, sensitive, reproducible, and cost-effective method for accurate MC assessment.
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Affiliation(s)
| | | | - Kristyna Pegova
- The Institute of Hematology and Blood Transfusion, Prague 2, Czech Republic
| | - Pavla Hrabakova
- The Institute of Hematology and Blood Transfusion, Prague 2, Czech Republic
| | - Renata Prerovska
- The Institute of Hematology and Blood Transfusion, Prague 2, Czech Republic
| | - Hana Cechova
- The Institute of Hematology and Blood Transfusion, Prague 2, Czech Republic
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9
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Tyler J, Kumer L, Fisher C, Casey H, Shike H. Personalized Chimerism Test that Uses Selection of Short Tandem Repeat or Quantitative PCR Depending on Patient's Chimerism Status. J Mol Diagn 2019; 21:483-490. [PMID: 30797064 DOI: 10.1016/j.jmoldx.2019.01.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 01/14/2019] [Accepted: 01/29/2019] [Indexed: 12/11/2022] Open
Abstract
Chimerism testing is used to monitor engraftment and risk of relapse after allogeneic hematopoietic stem cell transplantation for hematologic malignancies. Although short tandem repeat (STR) method is widely used among clinical laboratories, quantitative PCR (qPCR) provides better sensitivity (0.1%) than STR (1% to 5%) but is less accurate than STR for patients in mixed chimerism. qPCR chimerism allows evaluation of residual recipient cells as a surrogate of measurable residual disease. To achieve higher sensitivity and accuracy, we applied qPCR or STR based on patient chimerism status (recipient alleles <5% or ≥5%, respectively). Of the 230 patients tested by STR in a 1-year period, excluding 10 deceased patients, 30 qPCR markers were genotyped and 167 patients converted to qPCR chimerism (76%), including eight patients undergoing multiple-donor transplantation. STR was continued on 53 patients (24%) for the following reasons: mixed chimerism (n = 23), lack of donor or pretransplantation DNA (n = 22), and insufficient qPCR informative markers [8 of 60 patients with related donors (13.3%)]. qPCR detected residual recipient chimerism in 85.5% of patients with complete chimerism by STR (<5% recipient). Selecting STR or qPCR testing based on each patient's chimerism status facilitates sensitive and accurate chimerism testing in clinical settings. In addition, we discuss clinical relevance of chimerism testing for measurable residual disease detection in various hematologic malignancies.
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Affiliation(s)
- Jennifer Tyler
- Department of Pathology, Histocompatibility, and Immunogenetics, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Lorie Kumer
- Department of Pathology, Histocompatibility, and Immunogenetics, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Carolyn Fisher
- Department of Pathology, Histocompatibility, and Immunogenetics, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Heather Casey
- Department of Pathology, Histocompatibility, and Immunogenetics, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Hiroko Shike
- Department of Pathology, Histocompatibility, and Immunogenetics, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
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10
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Peng B, Liu H, Zhuang Q, Cheng K, Ming YZ. Detecting chimerism contributes to diagnosis of graft versus host disease after orthotopic liver transplantation. Hepatobiliary Pancreat Dis Int 2018; 17:363-366. [PMID: 30025606 DOI: 10.1016/j.hbpd.2018.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 06/25/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Bo Peng
- Transplantation Center of the Third Xiangya Hospital, Central South University, Changsha 410013, China; Engineering & Technology Research Center for Transplantation Medicine of National Ministry of Health, Changsha 410013, China
| | - Hong Liu
- Transplantation Center of the Third Xiangya Hospital, Central South University, Changsha 410013, China; Engineering & Technology Research Center for Transplantation Medicine of National Ministry of Health, Changsha 410013, China
| | - Quan Zhuang
- Transplantation Center of the Third Xiangya Hospital, Central South University, Changsha 410013, China; Engineering & Technology Research Center for Transplantation Medicine of National Ministry of Health, Changsha 410013, China
| | - Ke Cheng
- Transplantation Center of the Third Xiangya Hospital, Central South University, Changsha 410013, China; Engineering & Technology Research Center for Transplantation Medicine of National Ministry of Health, Changsha 410013, China
| | - Ying-Zi Ming
- Transplantation Center of the Third Xiangya Hospital, Central South University, Changsha 410013, China; Engineering & Technology Research Center for Transplantation Medicine of National Ministry of Health, Changsha 410013, China.
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11
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Ahci M, Stempelmann K, Buttkereit U, Crivello P, Trilling M, Heinold A, Steckel NK, Koldehoff M, Horn PA, Beelen DW, Fleischhauer K. Clinical Utility of Quantitative PCR for Chimerism and Engraftment Monitoring after Allogeneic Stem Cell Transplantation for Hematologic Malignancies. Biol Blood Marrow Transplant 2017; 23:1658-1668. [DOI: 10.1016/j.bbmt.2017.05.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 05/30/2017] [Indexed: 12/20/2022]
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