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Navarro-Bailón A, Carbonell D, Escudero A, Chicano M, Muñiz P, Suárez-González J, Bailén R, Oarbeascoa G, Kwon M, Díez-Martín JL, Martínez-Laperche C, Buño I. Short Tandem Repeats (STRs) as Biomarkers for the Quantitative Follow-Up of Chimerism after Stem Cell Transplantation: Methodological Considerations and Clinical Application. Genes (Basel) 2020; 11:genes11090993. [PMID: 32854376 PMCID: PMC7565503 DOI: 10.3390/genes11090993] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/19/2020] [Accepted: 08/23/2020] [Indexed: 01/06/2023] Open
Abstract
Chimerism refers to the relative proportion of donor and recipient DNA after hematopoietic stem cell transplantation (HSCT) and its quantitative follow-up is of great clinical utility in this setting. PCR of short tandem repeats (STR-PCR) constitutes the gold standard method for chimerism quantification, although more sensitive PCR techniques (such as qPCR) have recently arisen. We compared the sensitivity and the quantification capacity of both techniques in patient samples and artificial mixtures and demonstrated adequate performance of both methods, with higher sensitivity of qPCR and better quantification skills of STR-PCR. By qPCR, we then prospectively followed up 57 patients that were in complete chimerism (CC) by STR-PCR. Twenty-seven patients (59%) showed 0.1–1% recipient DNA in the bone marrow. Only 4 patients presented 0.1–1% recipient DNA in peripheral blood (PB), and one of them relapsed. Finally, by qPCR, we retrospectively studied the last sample that showed CC by STR-PCR prior to relapse in 8 relapsed patients. At a median of 59 days prior to relapse, six patients presented mixed chimerism by qPCR in PB. Since both approaches have complementary characteristics, we conclude that different techniques should be applied in different clinical settings and therefore propose a methodological algorithm for chimerism follow-up after HSCT.
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Affiliation(s)
- Almudena Navarro-Bailón
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
| | - Diego Carbonell
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - Asunción Escudero
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
| | - María Chicano
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - Paula Muñiz
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - Julia Suárez-González
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
- Genomics Unit, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Rebeca Bailén
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - Gillen Oarbeascoa
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - Mi Kwon
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
| | - José Luis Díez-Martín
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
- Department of Medicine, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Carolina Martínez-Laperche
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
- Genomics Unit, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Ismael Buño
- Department of Hematology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (A.N.-B.); (D.C.); (A.E.); (M.C.); (P.M.); (R.B.); (G.O.); (M.K.); (J.L.D.-M.)
- Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, 28007 Madrid, Spain; (J.S.-G.); (C.M.-L.)
- Genomics Unit, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Department of Cell Biology, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Correspondence: ; Tel.: +91-5868775
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