Chimerism analysis is important for monitoring engraftment and indicating the recurrence of malignant cells after allogeneic hematopoietic stem cell transplantation. Highly sensitive methods with a detection limit of recipient cells (equivalents) below 0.1% , e.g. quantitative PCR, can predict a relapse up to 120 days earlier when compared to less sensitive methods. This talk highlights the importance of assessing the dynamics of chimerism in the low percentage range (below 1%) for the prediction of a relapse. A classification of different chimerism kinetics with their reasonable underlying causal effects are shown together with some examples. The pros and cons of bone marrow samples versus peripheral blood sample in the context with high sensitive chimerism analysis methods are discussed.

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