单核苷酸多态性-PCR检测供者细胞嵌合率对年轻中危急性髓系白血病患者异基因造血干细胞移植后的预后价值

OBJECTIVE: To investigate the relationship between donor chimerism and relapse after allogeneic hematopoietic stem cell transplantation（allo-HSCT）. METHODS: The clinical data of 105 patients with acute myeloid leukemia（AML）who underwent allo-HSCT and recurrence-free survival >90 days from January 2010 to January 2019 were retrospectively analyzed. The bone marrow samples were collected at 15, 30, 60, 90, 180, 270, 360 days after transplantation. Donor chimerism was detected by single nucleotide polymorphism（SNP）-PCR. RESULTS: Of the 105 patients, 43 cases were male and 62 cases were female, with a median age of 38（16–60）years. Till April 2019, the median follow-up was 843（94–3 261）days. Ninety days after transplantation, 18 cases relapsed, 33 cases died, and 72 cases survived. The 3-year overall survival（OS）rate was（66.8±5.1）％, and the recurrence-free survival（RFS）rate was（65.1±5.0）％. Pre-transplant disease status, pre-transplant minimal residual disease（MRD）, and 90 day post-transplantation chimerism were independent risk factors related to RFS. The risk of recurrence was significantly increased in patients with a donor chimerism rate ≤97.24％ at 90 days after transplantation［HR=6.921（95％CI 2.669–17.950）, P<0.001］, which was considered as a sign of early relapse. CONCLUSION: SNP-PCR is an applicable method for detecting donor chimerism in patients after allo-HSCT. Chimerism rate equal or less than 97.24％ at 90 days after transplantation predicts a higher risk of relapse.