Frontiers in Oncology (Mar 2023)

Bone marrow CD34+ molecular chimerism as an early predictor of relapse after allogeneic stem cell transplantation in patients with acute myeloid leukemia

  • Michele Malagola,
  • Nicola Polverelli,
  • Alessandra Beghin,
  • Federica Bolda,
  • Marta Comini,
  • Mirko Farina,
  • Enrico Morello,
  • Vera Radici,
  • Eugenia Accorsi Buttini,
  • Simona Bernardi,
  • Simona Bernardi,
  • Federica Re,
  • Federica Re,
  • Alessandro Leoni,
  • Alessandro Leoni,
  • Davide Bonometti,
  • Duilio Brugnoni,
  • Arnalda Lanfranchi,
  • Domenico Russo

DOI
https://doi.org/10.3389/fonc.2023.1133418
Journal volume & issue
Vol. 13

Abstract

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BackgroundMinimal residual disease (MRD) monitoring is an important tool to optimally address post-transplant management of acute myeloid leukemia (AML) patients.MethodsWe retrospectively analyzed the impact of bone marrow CD34+ molecular chimerism and WT1 on the outcome of a consecutive series of 168 AML patients submitted to allogeneic stem cell transplantation.ResultsThe cumulative incidence of relapse (CIR) was significantly lower in patients with donor chimerism on CD34+ cells ≥ 97.5% and WT1 < 213 copies/ABL x 10^4 both at 1st month (p=0.008 and p<0.001) and at 3rd month (p<0.001 for both). By combining chimerism and WT1 at 3rd month, 13 patients with chimerism < 97.5% or WT1 > 213 showed intermediate prognosis. 12 of these patients fell in this category because of molecular chimerism < 97.5% at a time-point in which WT1 was < 213.ConclusionsOur results confirm that lineage-specific molecular chimerism and WT1 after allo-SCT (1st and 3rd month) are useful MRD markers. When considered together at 3rd month, CD34+ molecular chimerism could represent an earlier predictor of relapse compared to WT1. Further studies are necessary to confirm this preliminary observation.

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