scholarly journals Systematic comparison of donor chimerism in peripheral blood and bone marrow after hematopoietic stem cell transplantation

2017 ◽  
Vol 7 (6) ◽  
pp. e566-e566 ◽  
Author(s):  
C Bach ◽  
M Steffen ◽  
W Roesler ◽  
J Winkler ◽  
A Mackensen ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Peripheral Blood ◽  
Hematopoietic Stem ◽  
Systematic Comparison ◽  
Donor Chimerism

Monitoring of Bone Marrow Chimerism after Allogeneic Hematopoietic Stem Cell Transplantation – Evaluation of a qPCR Based Chimerism Assay

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3866-3866 ◽  
Author(s):  
Roland Reibke ◽  
Andrea Dick ◽  
Max Hubmann ◽  
Eva Hoster ◽  
Reinhard Henschler ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Early Detection ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem ◽  
Allogeneic Hsct ◽  
Donor Chimerism

Abstract Allogeneic hematopoietic stem cell transplantation (HSCT) has become a valuable therapeutic option for malignant and non-malignant hematological diseases. Engraftment of donor cells is confirmed by repetitive testing for donor chimerism. Since the underlying malignant disease is host derived, the decrease of donor chimerism might precede or indicate the imminent relapse, enabling early intervention and presumably better outcome. STR-assay (Short-Tandem-Repeats-Assay) and XY-FISH (XY based Fluorescence in Situ Hybridization) respectively are routinely performed after HSCT. Furthermore CD34+ cell- chimerism and quantification of minimal residual disease in patients with informative markers might be used to detect early relapse. In this prospective, non-interventional study we evaluated the accuracy, reliability and feasibility of a qPCR based commercially available assay (Allele SEQR® Chimerism Assay, Abbott). In addition, the early detection of hematological relapse was analyzed as a clinical readout. Between May 2011 and January 2013 95 patients received allogeneic HSCT for MDS or acute leukemia (AML = 84) at our transplantation unit and were therefore included in our analysis. According to our local standard bone marrow samples were collected at standardized time points including days 30, 90, 180. The qPCR based Allele SEQR® Chimerism Assay consists of two parts: screening for discriminating, informative markers and subsequent actual quantification of the host DNA. For assay validation 68 patients were suitable. In all patient/donor pairs at least one informative marker could be found and quantitative results could be achieved. In 65/68 pairs (95.6%) even ≥ 2 markers could be identified, however, among 28 related donors three (10.7%) only revealed one discriminating marker. The sensitivity of the assay was proven by means of artificially spiked DNA samples mimicking an amount of 0.1%, 0.05% and 0.01% of “host“ DNA respectively. Testing was performed with 100ng/well patient DNA. The overall time needed for testing was less than four hours. We identified 61 patients with at least two samples in cytomorphological complete remission (CR) after allogeneic HSCT. The overall hematological relapse rate in our cohort was 23% until March 2014. To enable relapse prediction we quantified donor chimerism in CR samples. Scoring for suspicious results by the increase of host chimerism by at least one percent point, but not less than one third as compared to previous testing, was highly predictive for imminent relapse (overall relapse rate 86% vs. 15%, p=<0,001, Mantel-Byar Test). Median time from increased host chimerism to relapse was 68 days (25-201). Furthermore no patient relapsed within 120days without prior positive testing. The evaluated qPCR approach proved as a fast and highly sensitive tool for chimerism monitoring after HSCT. It may allow an early detection or exclusion of imminent relapse, enabling chimerism triggered therapy. In perspective we will validate this assay for peripheral blood samples, allowing more convenient and frequent testing. Disclosures Reibke: Abbott molecular Germany: Research Funding.

Haploidentical Hematopoietic Stem Cell Transplantation for Acquired Severe Aplastic Anemia

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 3227-3227 ◽  
Author(s):  
Miao Miao ◽  
Xiang Zhang ◽  
Ting Xu ◽  
Song Jin ◽  
Hong Wang ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Aplastic Anemia ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Peripheral Blood ◽  
Hematopoietic Stem ◽  
Acquired Severe Aplastic Anemia

Abstract Objective: To evaluate the efficacy and safety of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in patients with acquired severe aplastic anemia (SAA), who lacked suitable related or unrelated HLA-matched donors. Methods: 39 SAA patients underwent haplo-HSCT from Jul 2012 to Jun 2015 at our center. There were 23 males and 16 females at a median follow-up of 11 (range, from 0 to 36) months. The median time from diagnosis to transplantation was 1 (range, from 0.5 to 52) months. The median ages of SAA patients and related haploidentical donor were 23 years (range, 9 to 51years) and 45 (range, from 21 to 61) years, respectively. All patients were given BuCy plus ATG conditioning regimen. GVHD prophylaxis regimen consisted of cyclosporine A (CsA), mycophenolate motetil (MMF), and short-term methotrexate. Results: Stem cells were collected from bone marrow in 23.08% (n=9) of patients, peripheral blood in 2.56% (n=1), bone marrow plus peripheral blood in 74.36% (n=29) patients. 36 patients received haplo-HSCT combined with the third part of cord blood transfusion 92.31%. The median stem cell dose transplanted was 9.76 (range, from 4.02 to 20.10)×108/kg for mononuclear cells, while 3.4 (range, from 1.05 to 8.60)×108/kg for CD34 cells. 36 patients achieved neutrophil engraftment at a median of 12 (range, from 9 to 28) , and 29 patients achieved platelet engraftment at a median of 29 (range, from 10 to 26) days. Cumulative incidence of III°~IV° acute graft versus host disease (aGVHD) was 8.9±4.9%. 6 patients died of transplant-related mortality (TRM), including 4 from severe infection, and 1 from TMA. The overal survival rate of all patients was 83.2%±6.4% Conclusions: Haplo-HSCT is likely to be an option for SAA patients without suitable related or unrelated HLA-matched donors, in consideration of the acceptable TRM and severe GVHD incidences. Disclosures No relevant conflicts of interest to declare.

scholarly journals The Role of Macrophages in Bone Marrow Injury and Hematopoietic Reconstitution

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3729-3729
Author(s):  
Wen Ju ◽  
Tiantian Sun ◽  
Wenyi Lu ◽  
Kailin Xu ◽  
Jianlin Qiao ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Peripheral Blood ◽  
Blood Cells ◽  
Sublethal Dose ◽  
Hematopoietic Stem

Introduction Successful homing, engrafment and effective hematopoietic recovery after hematopoietic stem cell transplantation (HSCT) are strictly regulated by various hematopoietic microenvironment cells. Increasing evidence shows that macrophages (MФs), one of the most important component niche cells are crucial for the haematopoietic regulation. MФs depletion can enhance hematopoietic stem cell mobilization. Our previous study showed that MФs ameliorate bone marrow inflammatory injury and promote hematopoiesis in mice after allo-HSCT, but its role in syngeneic HSCT and acute bone marrow injury is still unknown. Our aim is to explore the role of macrophages in acute bone marrow injury and hematopoietic reconstitution after isogenic hematopoietic stem cell transplantation and sublethal dose irradiation in vivo. Methods BALB/c male mice at 8-10 weeks were irradiated with 60 Co 7.5 Gy and 3.0 Gy, respectively, and then isogenic hematopoietic stem cell transplantation model and sublethal-dose bone marrow injury model were constructed. The transplantation model mice were randomly divided into total body irradiation group (TBI group), bone marrow cell transplantation group (BMT group), bone marrow cell transplantation + Clodronate Liposomes injection group (BMT+Clod-Lip group), bone marrow cell transplantation + PBS Liposomes injection group ( BMT + PBS-Lip group), and normal control group (Normal group). The sublethal-dose experimental mice were randomly divided into the total body irradiation group (TBI group), the whole body irradiation + Clodronate Liposomes injection group (TBI+Clod-Lip group), the whole body irradiation + PBS Liposomes injection group (TBI+PBS-Lip group), and normal control group (Normal group). Mice in Clod-Lip group were injected with Clodronate Liposomes for several specific times to deplete macrophages until the specimens were obtained. Mice in PBS-Lip group were injected PBS Liposomes as controls.Then, the living conditions and body weight changes of the mice were observed and the survival rates of mice in different experimental groups were recorded. Peripheral blood and bone marrow in each group were collected at the corresponding detection time, blood routine analyzer was used to detect blood routine changes, HE staining was used to observe bone marrow damage, and flow cytometry was used to analyze changes in macrophages, hematopoietic stem/progenitor cells and their subgroups such as myeloid cells, megakaryocytes, and nucleated red blood cells in bone marrow. Results Depletion of bone marrow macrophages could reduce the survival rate of hematopoietic stem cell transplantation mice. The pathological results of bone marrow showed that bone marrow injury were heaviest on the 7th day in all three transplantation groups, and then gradually alleviated. The recovery of the BMT+Clod-Lip group was inferior to that of the BMT+PBS-Lip group and the BMT group at the corresponding time point. Depletion of macrophages increased the percentage of myeloid cells in the bone marrow and the number of white blood cells in the peripheral blood, reduced the total number of bone marrow cells, the proportion of hematopoietic stem cells and megakaryocytes in the bone marrow, and delayed recovery of red blood cells and platelets in peripheral blood; Depletion of bone marrow macrophages could also reduce survival rate of sublethal dose irradiation mice, delayed the repair of pathological damage of bone marrow, and increase the proportion of progenitor cells, CMP, GMP, myeloid cells and the number of peripheral white blood cells ,increase the proportion of hematopoietic stem cell apoptosis, reduce the total number of bone marrow cells, the proportion of hematopoietic stem cells, MEP, megakaryocytes and nucleated red blood cells in the bone marrow, delayed peripheral blood recovery of red blood cells and platelets. Conclusion In the isogenic hematopoietic stem cell transplantation model and the sublethal dose irradiation mouse model, the removal of mouse bone marrow macrophages could affect the survival rate of transplanted mice, aggravate the pathological damage of bone marrow, increase the number of GMP and white blood cells, and reduce the total number of bone marrow cells, the number of hematopoietic stem cells and MEP cells. Macrophage depletion was not conducive to the recovery of peripheral blood red blood cells and platelets. Disclosures No relevant conflicts of interest to declare.

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