NCI First International Workshop on the Biology, Prevention, and Treatment of Relapse after Allogeneic Hematopoietic Stem Cell Transplantation: report from the Committee on Disease-Specific Methods and Strategies for Monitoring Relapse following Allogeneic Stem Cell Transplantation. Part I: Methods, acute leukemias, and myelodysplastic syndromes.
NCI First International Workshop on the Biology, Prevention, and Treatment of Relapse after Allogeneic Hematopoietic Stem Cell Transplantation: report from the Committee on Disease-Specific Methods and Strategies for Monitoring Relapse following Allogeneic Stem Cell Transplantation. Part I: Methods, acute leukemias, and myelodysplastic syndromes.
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DOI：
10.1016/j.bbmt.2010.06.008
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发表时间：
2010-09
期刊：
影响因子：
--
通讯作者：
Wayne AS
中科院分区：
文献类型：
--
作者：
Kröger N;Bacher U;Bader P;Böttcher S;Borowitz MJ;Dreger P;Khouri I;Macapinlac HA;Olavarria E;Radich J;Stock W;Vose JM;Weisdorf D;Willasch A;Giralt S;Bishop MR;Wayne AS
复发已成为异基因干细胞移植后治疗失败的主要原因。移植后临床复发患者的预后一般较差，但在恶性血液病复发之前进行干预可改善某些恶性血液病的预后。为了检测早期复发或微小残留疾病，分子遗传学、肿瘤特异性分子引物、荧光原位杂交(FISH)和多参数流式细胞术(MFC)等敏感方法常用于监测异基因干细胞移植后的患者，但并不是所有的方法都包括在常用的疾病特异性反应标准中。通过基于聚合酶链式反应技术测量的肿瘤或患者特异性标志物的分子监测可以实现最高的敏感性和特异性，但并不是所有的疾病都有这样的监测目标。通过确定供者嵌合体也可以达到类似的高灵敏度，但它对检测复发的特异性较低，并且在不同疾病之间存在很大差异。在这里，我们总结了目前关于基于肿瘤特异性标志物和供体细胞嵌合体的这种敏感监测技术的应用知识，以及这些方法如何增强移植后缓解、持续性、进展性、复发和复发预测的标准定义。至关重要的是，需要对不同的残留病技术进行标准化，并评估微小残留病和单个疾病的嵌合体监测的临床相关性，随后必须进行研究，以评估特定干预策略的潜在影响。
Relapse has become the major cause of treatment failure after allogeneic stem cell transplantation. Outcome of patients with clinical relapse after transplantation generally remains poor, but intervention prior to florid relapse improves outcome for certain hematologic malignancies. To detect early relapse or minimal residual disease, sensitive methods such as molecular genetics, tumor specific molecular primers, fluorescence in situ hybridisation (FISH), and multiparameter flow cytometry (MFC) are commonly used after allogeneic stem cell transplantation to monitor patients, but not all of them are included in the commonly employed disease-specific response criteria. The highest sensitivity and specificity can be achieved by molecular monitoring of tumor- or patient-specific markers measured by polymerase chain reaction-based techniques, but not all diseases have such targets for monitoring. Similar high sensitivity can be achieved by determination of donor chimerism, but its specificity regarding detection of relapse is low and differs substantially among diseases. Here we summarize the current knowledge about the utilization of such sensitive monitoring techniques based on tumor specific markers and donor cell chimerism and how these methods might augment the standard definitions of post-transplant remission, persistence, progression, relapse and the prediction of relapse. Critically important is the need for standardization of the different residual disease techniques and to assess the clinical relevance of minimal residual disease and chimerism surveillance in individual diseases, which in turn must be followed by studies to assess the potential impact of specific interventional strategies.
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影响因子：
4.8
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