Abstract
The importance of chimerism is that it is useful to demonstrate engraftment. It allows for early intervention which might facilitate treatment of emerging relapse in leukemia, and it may help to prevent graft rejection. The aim of this study is to evaluate mixed red cell population and red blood cell chimerism after hematopoietic stem cell transplantation to predict the final outcome of mixed chimerism which may help in deciding interventions and preventing graft rejection. This study was conducted on 22 bone marrow-transplanted patients admitted to Bone Marrow Transplantation (BMT) Unit, Nasser institute, using simple agglutination method and flow cytometery (FCM) technique. In our study, three recipients had complete chimerism after 6 month which was detected by agglutination method, and one recipient had complete chimerism after 1 year which was detected by both simple agglutination method and FCM. Two recipients had mixed-field agglutination after 30 days which was detected by agglutination method and FCM. Evaluating erythrocyte repopulation by the agglutination method is feasible, easy, and cost-effective. FCM analysis is a simple, sensitive test and an objective method, which could be used as a protocol for follow-up to detect chimerism after allogeneic BMT. However, due to the difficulty found in retrieving the patients for follow-up, we suggest the use of alternative methods for detection of chimerism as variable number of tandem repeats and XY fluorescence in situ hybridization probe.
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References
Bader P, Kreyenberg H (2004) Analysis of chimerism after stem cell transplantation. Methods Mol Med 91:247–264
Blanchard D, Bruneau V, Bernard D et al (1995) Flow cytometric analysis of dual red blood cell populations after bone marrow transplantation. Br J Haematol 89:741–747
Bolan CD, Leitman SF, Griffith LM et al (2001) Delayed donor red cell chimerism and pure red cell aplasia following major ABO- + incompatible nonmyeloablative hematopoietic stem cell transplantation. Blood 98:1687–1694
David B, Bernard D, Navenot JM et al (1999) Flow cytometric monitoring of red blood cell chimerism after bone marrow transplantation. Transfus Med 9:209–217
Faize M, Faize L, Burgo L (2010) Using quantitative real-PCR to detect chimeras in transgenic tobacco and apricot and to monitor their dissociation. BMC Biotechnol 10:53
Hendriks EC, de Man AJ, van Berkel YC et al (1997) Flow cytometric method for the routine follow-up of red cell populations after bone marrow transplantation. Br J Haematol 97:141–145
Huisman C, de Weger RA, de Vries L et al (2007) Chimerism analysis within 6 months of allogeneic stem cell transplantation predicts relapse in acute myeloid leukemia. Bone Marrow Transplant 39:285–291
Lucarelli G, Gaziev J (2008) Advances in the allogeneic transplantation for thalassemia. Blood Rev 22:53–63
Petz LD (1991) The expanding boundaries of transfusion medicine. In: Nance ST (ed) Clinical and basic science aspects of immunohematology. American Association of Blood Banks, Arlington, Virginia, pp 75–115
Ralston A, Rossant J (2005) Genetic regulation of stem cell origins in the mouse embryo. Clin Genet 68(2):106–112
Schaap N, Schattenberg A, Bar B et al (2000) Red blood cell phenotyping is a sensitive technique for monitoring chronic myeloid leukaemia patients after T-cell-depleted bone marrow transplantation and after donor leucocyte infusion. Br J Haematol 108:116–125
Schumm M, Feuchtinger T, Pfeiffer M et al (2007) Flow cytometry with anti-HLA-antibodies: a simple but highly sensitive method for monitoring chimerism and minimal residual disease after HLA-mismatched stem cell transplantation. Bone Marrow Transplant 39:767–773
Shaiegan M, Hadjati E, Aghaiipour M et al (2006) Flow cytometric evaluation of red blood cell chimerism after bone marrow transplantation in Iranian patients: a preliminary study. Arch Iranian Med 9(4):406–409
Thiede C, Bornhäuser M, Oelschlägel U et al (2001) Sequential monitoring of chimerism and detection of minimal residual disease after allogeneic blood stem cell transplantation (BSCT) using multiplex PCR amplification of short tandem repeat-markers. Leukemia 15:293–302
Van Dijk BA, Drenthe-Schonk AM, Bloo A et al (1987) Erythrocyte repopulation after allogeneic bone marrow transplantation. Analysis using erythrocyte antigens. Transplantation 44:650–654
Wennerberg A, Backman KA, Gillerlain C et al (1996) Mixed erythrocyte chimerism: implications for tolerance of the donor immune system to recipient non-ABO system red cell antigens. Bone Marrow Transplant 18:433–435
Westhoff CM (2007) The structure and function of the Rh antigen complex. Semin Hematol 44(1):42–50
Wu CJ, Gladwin M, Tisdale J et al (2007) Mixed haematopoietic chimerism for sickle cell disease prevents intravascular haemolysis. Br J Haematol 139:504–507
Yam PY, Petz LD, Knowlton RG et al (1987) Use of DNA restriction fragment length polymorphisms to document marrow engraftment and mixed hematopoietic chimerism following bone marrow transplantation. Transplantation 43:399–407
Yldrm I, Özer Y, Yüksel MK et al (2004) Erythrocyte antigen and reticulocyte engraftment after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 34:351–355
Zhou M, Sheldon S, Akel N et al (1999) Chromosomal aneuploidy in leukemic blast crisis: a potential source of error in interpretation of bone marrow engraftment analysis by VNTR amplification. Mol Diagn 4:153–157
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El Enein, A.A., Afify, R.A.A., Soliman, D.M. et al. Follow-up of the patients after bone marrow transplantation for red blood cell chimerism using flow cytometry. Comp Clin Pathol 23, 111–118 (2014). https://doi.org/10.1007/s00580-012-1580-9
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DOI: https://doi.org/10.1007/s00580-012-1580-9