Footnote:
Hinweis: Link zur Erstveröffentlichung URL: https://doi.org/10.3389/fonc.2022.841608
Description:
Allogeneic hematopoietic stem cell transplantation (alloHCT) represents the only
potentially curative treatment in high-risk AML patients, but up to 40% of patients suffer
from relapse after alloHCT. Treatment of overt relapse poses a major therapeutic
challenge and long-term disease control is achieved only in a minority of patients. In
order to avoid post-allograft relapse, maintenance as well as pre-emptive therapy
strategies based on MRD-detection have been used. A prerequisite for the
implementation of pre-emptive therapy is the accurate identification of patients at risk
for imminent relapse. Detection of measurable residual disease (MRD) represents an
effective tool for early relapse prediction in the post-transplant setting. However, using
established MRD methods such as multicolor flow cytometry or quantitative PCR,
sensitive MRD monitoring is only applicable in about half of the patients with AML and
advanced MDS undergoing alloHCT. Donor chimerism analysis, in particular when
performed on enriched leukemic stem and progenitor cells, e.g. CD34+ cells, is a
sensitive method and has emerged as an alternative option in the post alloHCT setting.
In this review, we will focus on the current strategies for lineage specific chimerism
analysis, results of pre-emptive treatment using this technology as well as future
developments in this field.