Genetic tests for selecting haematopoietic stem cell donors and post-transplant monitoring
Authors:
M. Vraná; H. Čechová; K. Pegová; S. Nazarová; A. Vítek
Authors‘ workplace:
Ústav hematologie a krevní transfuze, Praha
Published in:
Transfuze Hematol. dnes,23, 2017, No. Supplementum1, p. 68-74.
Category:
Overview
Allogeneic haematopoietic stem cell transplantation is one of the curative approaches in haematological malignancies. The aim of our work was to analyse the influence of genetic tests used in the selection of stem cell donor and post-transplant monitoring on patient survival post-transplant. The analysed cohort consisted of 611 transplantations from HLA matched donors.
The section of donor selection assessed the impact of HLA test accuracy. The cohort analysed in this section included 292 patients transplanted from unrelated donors. It was divided according to the genetic methods used. The results showed a statistically significant difference between the group of patients with HLA match genetically determined in HLA class II only and the group with both HLA I and II match tested, respectively (p =value 0.0189). The accuracy of the methods used (PCR with sequence specific primers vs. Sanger sequencing) did not significantly affect the survival of the transplanted patients (p = 0.6077).
The section of post-transplant monitoring evaluated the degree of cell chimerism (complete, mixed, microchimerism) and the method used. This section analysed 474 patients transplanted from unrelated and related donors. A significant difference in survival was observed between patients with complete and mixed chimerism, respectively: p < 0.0001 using Variable Number of Tandem Repeats analysis in combination with Short Tandem Repeats analysis and p = 0.0002 using highly sensitive quantitative real-time PCR.
Detection of mixed chimerism is thus a high-risk factor in the post-transplantation course. The group of patients with microchimerism (p = 0.0201) was also shown to be potentially at risk.
The selection of a suitable donor based on genotypic HLA match and cell chimerism monitoring after transplantation using sensitive methods are prerequisites of a successful allo-HSCT.
KEY WORDS:
HLA – chimerism – allo-HSCT – qPCR
Sources
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Labels
Haematology Internal medicine Clinical oncologyArticle was published in
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