PMID- 9590660
OWN - NLM
STAT- MEDLINE
DCOM- 19980603
LR  - 20061115
IS  - 0301-472X (Print)
IS  - 0301-472X (Linking)
VI  - 26
IP  - 5
DP  - 1998 May
TI  - Quantitative assessment of hematopoietic chimerism after allogeneic bone marrow 
      transplantation has predictive value for the occurrence of irreversible graft 
      failure and graft-vs.-host disease.
PG  - 426-34
AB  - Primary graft failure, secondary to either host-vs.-graft reaction or delayed 
      engraftment, and graft-vs.-host disease (GVHD) are among the most difficult 
      clinical problems to manage in the field of allogeneic bone marrow 
      transplantation (BMT). Early diagnosis of both conditions would greatly improve 
      their outcome. Using fluorescence in situ hybridization (FISH) with an X- and 
      Y-probe mixture, we sequentially monitored chimerism of neutrophils and lymphoid 
      cells from day 1 to 100 in 28 consecutive recipients of sex-mismatched 
      unmanipulated bone marrow grafts. The objective was to quantitatively assess the 
      evolution of chimerism during this crucial time interval and to determine whether 
      chimerism patterns would be predictive of engraftment and GVHD. In recipients 
      with primary graft failure (n=7), the presence of donor-type neutrophils and NK 
      cells as well as the predominance of donor-type T cells distinguished patients 
      who responded to G-CSF (n=5) from nonresponders (n=2). Furthermore, the clearance 
      of host CD3+CD56- cells during days 5-10 posttransplantation was significantly 
      hastened in patients who subsequently developed acute (delta=80%) or chronic 
      (delta=81%) GVHD compared with patients without GVHD (delta=17%). Thus, our data 
      suggest that molecular monitoring of the fate of host/donor hematopoietic cells 
      in the early posttransplantation period could be useful in differentiating 
      patients with delayed engraftment from those with irreversible rejection and in 
      predicting the occurrence of GVHD as soon as day 10. This investigational 
      approach may provide an appropriate basis on which to select adequate treatment 
      for primary graft failure and high-risk candidates that could benefit from novel 
      preemptive therapies for GVHD.
FAU - Gyger, M
AU  - Gyger M
AD  - Department of Hematology and Research Center, Maisonneuve-Rosemont Hospital, 
      University of Montreal, Quebec, Canada.
FAU - Baron, C
AU  - Baron C
FAU - Forest, L
AU  - Forest L
FAU - Lussier, P
AU  - Lussier P
FAU - Lagace, F
AU  - Lagace F
FAU - Bissonnette, I
AU  - Bissonnette I
FAU - Belanger, R
AU  - Belanger R
FAU - Bonny, Y
AU  - Bonny Y
FAU - Busque, L
AU  - Busque L
FAU - Roy, D C
AU  - Roy DC
FAU - Perreault, C
AU  - Perreault C
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Netherlands
TA  - Exp Hematol
JT  - Experimental hematology
JID - 0402313
RN  - 9007-49-2 (DNA)
SB  - IM
MH  - *Bone Marrow Transplantation/immunology
MH  - DNA/analysis
MH  - Graft Rejection/*epidemiology/etiology
MH  - Graft Survival
MH  - Graft vs Host Disease/*epidemiology/etiology
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Sex Factors
MH  - Transplantation Chimera/genetics/*physiology
MH  - *Transplantation, Homologous
EDAT- 1998/05/20 00:00
MHDA- 1998/05/20 00:01
CRDT- 1998/05/20 00:00
PHST- 1998/05/20 00:00 [pubmed]
PHST- 1998/05/20 00:01 [medline]
PHST- 1998/05/20 00:00 [entrez]
PST - ppublish
SO  - Exp Hematol. 1998 May;26(5):426-34.