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Lessons Learned from Donor Cell-Derived Myeloid Neoplasms: Report of Three Cases and Review of the Literature. Life (Basel) 2022; 12:life12040559. [PMID: 35455050 PMCID: PMC9028156 DOI: 10.3390/life12040559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/29/2022] [Accepted: 04/01/2022] [Indexed: 11/16/2022] Open
Abstract
Donor-cell derived myeloid neoplasm (DDMN), a rare complication after allogeneic hematopoietic cell transplantation (HCT), is of interest for its potential to reveal donor-derived and host-derived factors that contribute to the pathogenesis of leukemia. The accurate diagnosis of donor-derived leukemias has been facilitated by the more frequent use of molecular techniques. In this study, we describe three additional cases of DDMN; the first reported case of donor-derived chronic myelomonocytic leukemia (CMML), one acute myeloid leukemia (AML) with t(8;21)(q22;22); RUNX1-RUNX1T1 and one donor-derived MDS with deletion 5q. A review of the cytogenetic profiles of previously reported DDMN indicates a significant contribution of therapy-related myeloid neoplasms. Cases with direct evidence of donor- or recipient-dependent factors are rare; a role of direct transfer of leukemic cells, genomic instability of the donor, abnormal gene methylation in donor cells, proleukemic potential of abnormal stromal niche, and the role of immunological surveillance after transplantation has been observed. The role of additional potential pathogenetic factors that are without clinically observed evidence are also reviewed.
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2
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Zhang S, Li L, Cao W, Li Y, Jiang Z, Yu J, Wan D. Donor cell leukemia/myelodysplastic syndrome after allogeneic stem cell transplantation: a rare phenomenon with more challenges for hematologists. ACTA ACUST UNITED AC 2021; 26:648-651. [PMID: 34474660 DOI: 10.1080/16078454.2021.1966224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Donor cell leukemia (DCL) or Donor cell myelodysplastic syndrome (DC-MDS) is a rare type of leukemia or MDS and originates from the donor cells. It has very low frequency, but it seems to be steadily increasing as the physiopathology and mechanisms remain largely unknown. Here we report one case of acute lymphocytic leukemia (ALL) and one case of MDS of donor origin after allogeneic hematopoietic stem cell transplantation (HSCT). We also collated and reviewed literatures regarding DCL, and discuss the morbidity of DCL, the methods used to confirm donor origin and the etiology and pathogenesis of DCL. A new proposed theory will help us to better understand the mechanism for the oncogenesis of DCL.
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Affiliation(s)
- Suping Zhang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Li Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Weijie Cao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yingmei Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Zhongxing Jiang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Jifeng Yu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.,Academy of Medical and Pharmaceutical Sciences of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Dingming Wan
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
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3
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Williams L, Doucette K, Karp JE, Lai C. Genetics of donor cell leukemia in acute myelogenous leukemia and myelodysplastic syndrome. Bone Marrow Transplant 2021; 56:1535-1549. [PMID: 33686252 DOI: 10.1038/s41409-021-01214-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/21/2020] [Accepted: 01/07/2021] [Indexed: 01/31/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) is an important therapeutic modality for patients with acute myelogenous leukemia (AML) with poor risk features. Nonetheless, roughly 30% of such patients have leukemia recurrence and up to 2% of these are donor-derived leukemias, in which malignancy develops in the donor's transplanted cells, despite extremely low rates of leukemia in the donors themselves. Notably, over 20% of these malignancies carry chromosome 7 abnormalities nearly all of which are monosomies. Recent advances in whole exome and genome sequencing have allowed for detection of candidate genes that likely contribute to the development of AML in donor cells (donor leukemia, DCL). These genes include CEBPA, GATA2, JAK2, RUNX1, DDX41, EZH2, IDH1/2, DNMT3A, ASXL1, XPD, XRCC3, and CHEK1. The potential roles of variants in these genes are evaluated based on familial clustering of MDS/AML and corresponding animal studies demonstrating their leukemogenic nature. This review describes the spectrum of genetic aberrations detected in DCL cases in the literature with regard to the character of the individual cases, existing family cohorts that carry individual genes, and functional studies that support etiologic roles in AML development. DCL presents a unique opportunity to examine genetic variants in the donors and recipients with regards to progression to malignancy.
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Affiliation(s)
- Lacey Williams
- Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Kimberley Doucette
- Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Judith E Karp
- The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Catherine Lai
- Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC, USA.
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4
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Li Y, Gu L. Establishment and characterization of HXWMF-1: the first mouse fibroblastic tumor cell line derived from leukemia-associated fibroblasts. Cancer Cell Int 2021; 21:177. [PMID: 33740980 PMCID: PMC7977166 DOI: 10.1186/s12935-021-01870-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/06/2021] [Indexed: 11/20/2022] Open
Abstract
Background Chemo-resistance is still a major obstacle in leukemia treatment. Accumulating evidence indicates that cancer-associated fibroblasts (CAFs), the most abundant stromal cells in tumor microenvironment (TME), play a crucial role in cancer progression and response to chemotherapy. To Figure out the role of leukemia-associated fibroblasts (LAFs) in relapsed/refractory leukemia, we constructed the first leukemia-associated fibroblastic tumor cell line, HXWMF-1. Methods A cell culture technique was used to establish the leukemia-associated fibroblastic tumor cell line. Molecular and cellular biological techniques including flow cytometry, MTT assay, western blotting, and short tandem repeat (STR) analysis were used to characterize the cell line. Nude mice were used for xenograft studies. Results We established a LAFs derived tumor cell line HXWMF-1, originated from the subcutaneous xenografts of HXEX-ALL1, a cell line originated from a patient with acute lymphoblastic leukemia (ALL) at the second relapse. The HXWMF-1 cell line was authenticated as a tumor cell line and being derived from CAFs based on morphologic, immunophenotypic, cytogenetic and STR analyses and tumorigenicity test in nude mice. To clarify the reliability of the method, we got the LAFs derived tumor cells from three different tumor mass of HXEX-ALL1 xenografts. Conclusions To our knowledge, HXWMF-1 is the first fibroblastic tumor cell line derived from LAFs or CAFs. In addition, the cell line provided firm evidence for that leukemia cells may induce LAFs/CAFs malignant transformation, which may help to develop brand new theory and therapeutic strategies for patients with relapsed /refractory ALL.
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Affiliation(s)
- Yuanyuan Li
- Laboratory of Hematology/Oncology, Department of Pediatrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, 610041, People's Republic of China.,Joint Laboratory of West China Second University Hospital, Sichuan University and School of Life Science, Fudan University for Pulmonary Development and Disease, Chengdu, 610041, China
| | - Ling Gu
- Laboratory of Hematology/Oncology, Department of Pediatrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Chengdu, 610041, People's Republic of China. .,Joint Laboratory of West China Second University Hospital, Sichuan University and School of Life Science, Fudan University for Pulmonary Development and Disease, Chengdu, 610041, China.
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5
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Descriptive and Functional Genomics in Acute Myeloid Leukemia (AML): Paving the Road for a Cure. Cancers (Basel) 2021; 13:cancers13040748. [PMID: 33670178 PMCID: PMC7916915 DOI: 10.3390/cancers13040748] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/24/2021] [Accepted: 02/01/2021] [Indexed: 12/18/2022] Open
Abstract
Over the past decades, genetic advances have allowed a more precise molecular characterization of AML with the identification of novel oncogenes and tumor suppressors as part of a comprehensive AML molecular landscape. Recent advances in genetic sequencing tools also enabled a better understanding of AML leukemogenesis from the preleukemic state to posttherapy relapse. These advances resulted in direct clinical implications with the definition of molecular prognosis classifications, the development of treatment recommendations based on minimal residual disease (MRD) measurement and the discovery of novel targeted therapies, ultimately improving AML patients' overall survival. The more recent development of functional genomic studies, pushed by novel molecular biology technologies (short hairpin RNA (shRNA) and CRISPR-Cas9) and bioinformatics tools design on one hand, along with the engineering of humanized physiologically relevant animal models on the other hand, have opened a new genomics era resulting in a greater knowledge of AML physiopathology. Combining descriptive and functional genomics will undoubtedly open the road for an AML cure within the next decades.
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Aguirre-Ruiz P, Ariceta B, Viguria MC, Zudaire MT, Blasco-Iturri Z, Arnedo P, Aguilera-Diaz A, Jauregui A, Mañú A, Prosper F, Mateos MC, Fernández-Mercado M, Larráyoz MJ, Redondo M, Calasanz MJ, Vázquez I, Bandrés E. Assessment of Minimal Residual Disease by Next Generation Sequencing in Peripheral Blood as a Complementary Tool for Personalized Transplant Monitoring in Myeloid Neoplasms. J Clin Med 2020; 9:jcm9123818. [PMID: 33255857 PMCID: PMC7760908 DOI: 10.3390/jcm9123818] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 12/30/2022] Open
Abstract
Patients with myeloid neoplasms who relapsed after allogenic hematopoietic stem cell transplant (HSCT) have poor prognosis. Monitoring of chimerism and specific molecular markers as a surrogate measure of relapse is not always helpful; therefore, improved systems to detect early relapse are needed. We hypothesized that the use of next generation sequencing (NGS) could be a suitable approach for personalized follow-up post-HSCT. To validate our hypothesis, we analyzed by NGS, a retrospective set of peripheral blood (PB) DNA samples previously evaluated by high-sensitive quantitative PCR analysis using insertion/deletion polymorphisms (indel-qPCR) chimerism engraftment. Post-HCST allelic burdens assessed by NGS and chimerism status showed a similar time-course pattern. At time of clinical relapse in 8/12 patients, we detected positive NGS-based minimal residual disease (NGS-MRD). Importantly, in 6/8 patients, we were able to detect NGS-MRD at time points collected prior to clinical relapse. We also confirmed the disappearance of post-HCST allelic burden in non-relapsed patients, indicating true clinical specificity. This study highlights the clinical utility of NGS-based post-HCST monitoring in myeloid neoplasia as a complementary specific analysis to high-sensitive engraftment testing. Overall, NGS-MRD testing in PB is widely applicable for the evaluation of patients following HSCT and highly valuable to personalized early treatment intervention when mixed chimerism is detected.
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Affiliation(s)
- Paula Aguirre-Ruiz
- Hematological Diseases Laboratory, CIMA LAB Diagnostics, University of Navarra, 31008 Pamplona, Navarra, Spain; (P.A.-R.); (B.A.); (Z.B.-I.); (A.M.); (M.F.-M.); (M.J.L.); (M.J.C.)
| | - Beñat Ariceta
- Hematological Diseases Laboratory, CIMA LAB Diagnostics, University of Navarra, 31008 Pamplona, Navarra, Spain; (P.A.-R.); (B.A.); (Z.B.-I.); (A.M.); (M.F.-M.); (M.J.L.); (M.J.C.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Navarra, Spain; (M.C.V.); (M.T.Z.); (A.A.-D.); (F.P.); (M.C.M.); (M.R.)
| | - María Cruz Viguria
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Navarra, Spain; (M.C.V.); (M.T.Z.); (A.A.-D.); (F.P.); (M.C.M.); (M.R.)
- Hematology Department, Complejo Hospitalario de Navarra, 31008 Pamplona, Navarra, Spain; (P.A.); (A.J.)
| | - María Teresa Zudaire
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Navarra, Spain; (M.C.V.); (M.T.Z.); (A.A.-D.); (F.P.); (M.C.M.); (M.R.)
- Hematology Department, Complejo Hospitalario de Navarra, 31008 Pamplona, Navarra, Spain; (P.A.); (A.J.)
| | - Zuriñe Blasco-Iturri
- Hematological Diseases Laboratory, CIMA LAB Diagnostics, University of Navarra, 31008 Pamplona, Navarra, Spain; (P.A.-R.); (B.A.); (Z.B.-I.); (A.M.); (M.F.-M.); (M.J.L.); (M.J.C.)
| | - Patricia Arnedo
- Hematology Department, Complejo Hospitalario de Navarra, 31008 Pamplona, Navarra, Spain; (P.A.); (A.J.)
| | - Almudena Aguilera-Diaz
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Navarra, Spain; (M.C.V.); (M.T.Z.); (A.A.-D.); (F.P.); (M.C.M.); (M.R.)
- Advanced Genomics Laboratory, Hemato-Oncology, Center for Applied Medical Research (CIMA), 31008 Pamplona, Navarra, Spain
| | - Axier Jauregui
- Hematology Department, Complejo Hospitalario de Navarra, 31008 Pamplona, Navarra, Spain; (P.A.); (A.J.)
| | - Amagoia Mañú
- Hematological Diseases Laboratory, CIMA LAB Diagnostics, University of Navarra, 31008 Pamplona, Navarra, Spain; (P.A.-R.); (B.A.); (Z.B.-I.); (A.M.); (M.F.-M.); (M.J.L.); (M.J.C.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Navarra, Spain; (M.C.V.); (M.T.Z.); (A.A.-D.); (F.P.); (M.C.M.); (M.R.)
| | - Felipe Prosper
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Navarra, Spain; (M.C.V.); (M.T.Z.); (A.A.-D.); (F.P.); (M.C.M.); (M.R.)
- Advanced Genomics Laboratory, Hemato-Oncology, Center for Applied Medical Research (CIMA), 31008 Pamplona, Navarra, Spain
- Hematology Department, Clinica Universidad de Navarra (CUN), 31008 Pamplona, Navarra, Spain
| | - María Carmen Mateos
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Navarra, Spain; (M.C.V.); (M.T.Z.); (A.A.-D.); (F.P.); (M.C.M.); (M.R.)
- Hematology Department, Complejo Hospitalario de Navarra, 31008 Pamplona, Navarra, Spain; (P.A.); (A.J.)
| | - Marta Fernández-Mercado
- Hematological Diseases Laboratory, CIMA LAB Diagnostics, University of Navarra, 31008 Pamplona, Navarra, Spain; (P.A.-R.); (B.A.); (Z.B.-I.); (A.M.); (M.F.-M.); (M.J.L.); (M.J.C.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Navarra, Spain; (M.C.V.); (M.T.Z.); (A.A.-D.); (F.P.); (M.C.M.); (M.R.)
- Advanced Genomics Laboratory, Hemato-Oncology, Center for Applied Medical Research (CIMA), 31008 Pamplona, Navarra, Spain
| | - María José Larráyoz
- Hematological Diseases Laboratory, CIMA LAB Diagnostics, University of Navarra, 31008 Pamplona, Navarra, Spain; (P.A.-R.); (B.A.); (Z.B.-I.); (A.M.); (M.F.-M.); (M.J.L.); (M.J.C.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Navarra, Spain; (M.C.V.); (M.T.Z.); (A.A.-D.); (F.P.); (M.C.M.); (M.R.)
| | - Margarita Redondo
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Navarra, Spain; (M.C.V.); (M.T.Z.); (A.A.-D.); (F.P.); (M.C.M.); (M.R.)
- Hematology Department, Complejo Hospitalario de Navarra, 31008 Pamplona, Navarra, Spain; (P.A.); (A.J.)
| | - María José Calasanz
- Hematological Diseases Laboratory, CIMA LAB Diagnostics, University of Navarra, 31008 Pamplona, Navarra, Spain; (P.A.-R.); (B.A.); (Z.B.-I.); (A.M.); (M.F.-M.); (M.J.L.); (M.J.C.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Navarra, Spain; (M.C.V.); (M.T.Z.); (A.A.-D.); (F.P.); (M.C.M.); (M.R.)
| | - Iria Vázquez
- Hematological Diseases Laboratory, CIMA LAB Diagnostics, University of Navarra, 31008 Pamplona, Navarra, Spain; (P.A.-R.); (B.A.); (Z.B.-I.); (A.M.); (M.F.-M.); (M.J.L.); (M.J.C.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Navarra, Spain; (M.C.V.); (M.T.Z.); (A.A.-D.); (F.P.); (M.C.M.); (M.R.)
- Correspondence: (I.V.); (E.B.); Tel.: +34-948194700-1000 (I.V.)
| | - Eva Bandrés
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Navarra, Spain; (M.C.V.); (M.T.Z.); (A.A.-D.); (F.P.); (M.C.M.); (M.R.)
- Hematology Department, Complejo Hospitalario de Navarra, 31008 Pamplona, Navarra, Spain; (P.A.); (A.J.)
- Correspondence: (I.V.); (E.B.); Tel.: +34-948194700-1000 (I.V.)
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7
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Lee JM, Kim YJ, Park SS, Han E, Kim M, Kim Y. Simultaneous Monitoring of Mutation and Chimerism Using Next-Generation Sequencing in Myelodysplastic Syndrome. J Clin Med 2019; 8:jcm8122077. [PMID: 31795155 PMCID: PMC6947461 DOI: 10.3390/jcm8122077] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/02/2019] [Accepted: 11/21/2019] [Indexed: 01/27/2023] Open
Abstract
Monitoring minimal residual disease (MRD) provides important information during treatment of hematologic malignancies. Chimerism analysis also provides key information after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Recent advances in next-generation sequencing (NGS) have enabled identification of various mutations and quantification of mutant allele burden. In this study, we developed a new analytic algorithm to monitor chimerism applicable to NGS multi-gene panel in use to identify mutations of myelodysplastic syndrome (MDS). We enrolled patients who were diagnosed with MDS and received allo-HSCT and their corresponding donors. Monitoring MRD by NGS assay was performed using 53 DNA samples by calculating mutant allele burden after treatment. For monitoring chimerism by NGS, we selected 121 single nucleotide polymorphisms (SNPs) after careful stepwise evaluation and calculated average donor allele burden. Data obtained from NGS were compared with bone marrow findings, chromosome analysis and short tandem repeat (STR)-based chimerism. SNP-based NGS chimerism analysis was accurate and even superior to conventional STR method by overcoming the various technical limitations of STR. In addition, simultaneous monitoring of mutation and chimerism using NGS could implement comprehensive pre- and post-HSCT monitoring of various clinical conditions such as complete donor chimerism, persistent mixed chimerism, early relapse, and even donor cell-derived diseases.
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Affiliation(s)
- Jong-Mi Lee
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (J.-M.L.); (E.H.)
- Catholic Genetic Laboratory Center, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Yoo-Jin Kim
- Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (Y.-J.K.)
| | - Sung-Soo Park
- Department of Hematology, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (Y.-J.K.)
| | - Eunhee Han
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (J.-M.L.); (E.H.)
- Catholic Genetic Laboratory Center, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Myungshin Kim
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (J.-M.L.); (E.H.)
- Catholic Genetic Laboratory Center, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Correspondence: (M.K.); (Y.K.); Tel.: +82-2-2258-1645 (M.K.); +82-2-2258-1642 (Y.K.)
| | - Yonggoo Kim
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (J.-M.L.); (E.H.)
- Catholic Genetic Laboratory Center, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Correspondence: (M.K.); (Y.K.); Tel.: +82-2-2258-1645 (M.K.); +82-2-2258-1642 (Y.K.)
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8
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Bouvier A, Riou J, Thépot S, Sutra Del Galy A, François S, Schmidt A, Orvain C, Estienne MH, Villate A, Luque Paz D, Cottin L, Ribourtout B, Beucher A, Delneste Y, Ifrah N, Ugo V, Hunault-Berger M, Blanchet O. Quantitative chimerism in CD3-negative mononuclear cells predicts prognosis in acute myeloid leukemia patients after hematopoietic stem cell transplantation. Leukemia 2019; 34:1342-1353. [PMID: 31768015 DOI: 10.1038/s41375-019-0624-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 10/18/2019] [Accepted: 11/03/2019] [Indexed: 12/20/2022]
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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Affiliation(s)
- Anne Bouvier
- CHU Angers, Laboratoire d'Hématologie, Angers, France. .,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France. .,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.
| | - Jérémie Riou
- MINT, UMR INSERM 1066, CNRS 6021, Université d'Angers, Angers, France.,Université d'Angers, UFR Santé, Angers, France
| | - Sylvain Thépot
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Université d'Angers, UFR Santé, Angers, France.,CHU Angers, Service des Maladies du sang, Angers, France
| | | | - Sylvie François
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CHU Angers, Service des Maladies du sang, Angers, France
| | - Aline Schmidt
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Université d'Angers, UFR Santé, Angers, France.,CHU Angers, Service des Maladies du sang, Angers, France
| | - Corentin Orvain
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Université d'Angers, UFR Santé, Angers, France.,CHU Angers, Service des Maladies du sang, Angers, France
| | - Marie-Hélène Estienne
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CHU Tours, Service d'Hématologie biologique, Tours, France
| | - Alban Villate
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CHU Tours, Service d'Hématologie et thérapie cellulaire, Tours, France
| | - Damien Luque Paz
- CHU Angers, Laboratoire d'Hématologie, Angers, France.,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Université d'Angers, UFR Santé, Angers, France
| | - Laurane Cottin
- CHU Angers, Laboratoire d'Hématologie, Angers, France.,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,Université d'Angers, UFR Santé, Angers, France
| | - Bénédicte Ribourtout
- CHU Angers, Laboratoire d'Hématologie, Angers, France.,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France
| | - Annaëlle Beucher
- CHU Angers, Laboratoire d'Hématologie, Angers, France.,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France
| | - Yves Delneste
- CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,CHU Angers, Laboratoire d'Immunologie et Allergologie, Angers, France
| | - Norbert Ifrah
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Université d'Angers, UFR Santé, Angers, France.,CHU Angers, Service des Maladies du sang, Angers, France
| | - Valérie Ugo
- CHU Angers, Laboratoire d'Hématologie, Angers, France.,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Université d'Angers, UFR Santé, Angers, France
| | - Mathilde Hunault-Berger
- Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Université d'Angers, UFR Santé, Angers, France.,CHU Angers, Service des Maladies du sang, Angers, France
| | - Odile Blanchet
- CHU Angers, Laboratoire d'Hématologie, Angers, France.,Fédération Hospitalo-Universitaire 'Grand Ouest Against Leukemia' (FHU GOAL), Angers, France.,CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France.,Université d'Angers, UFR Santé, Angers, France.,CHU Angers, Centre de Ressources Biologiques, BB-0033-00038, Angers, France
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