Highly Sensitive Chimerism Testing to Detect Early Leukemia Relapse Post-Allo-Transplantation

ABST RACT Patients with acute blood malignancies who undergo allogeneic hematopoietic stem cell transplantationHSCTare monitored for minimal residual diseaseMRDas predictive of relapseIncreasing mixed chimerismreemerging recipient cellscorrelates with reappearance of underlying disease by association with MRDGenetic and immunophenotypic heterogeneity of these malignancies often prevents establishing reliable MRD markersin which case donor vsrecipient chimerism testing becomes the best option as a surrogate marker for MRDAt presentthe widely usedgold standardin chimerism analysis is techniques characterizing short tandem repeatsSTRwith a limit of detectionthus unsuitable as a strategy for early relapse detectionNew technologies to predict relapse post HSCT are critical to provide rapid and individualized therapeutic assessmentChimerocyteIncis developing the Microchimerism Panelcomposed of polymorphism specific primers and fluorogenic probes to detect and quantify non shared polymorphisms with limit of detection several orders of magnitude lower than currently available testsdetecting up tocell equivalent perbackground cellsTo increase the probability of having an informative markerChimerocyte aims at developing additional highly sensitive polymorphism specific assays thus expanding the panelFurthermorewe hypothesize that by sensitively monitoring chimerism using our technologyimminent relapse will be predicted with superior accuracy compared to clinical standard of careWe propose to test the Microchimerism Panel on post transplant samples fromleukemia patients for its ability to differentiate relapse vssustained remissionOur collaborators have previously collected samples from regular intervals post transplantResults will be compared to clinical standardof care chimerism testing to demonstrate the ability of Chimerocyte s Microchimerism panel in rapid high risk patient identificationWe anticipate a successful outcome that will significantly benefit cancer diagnostics and ther apy PROJECT NARRATIVE Increasing mixed chimerismreemerging recipient cellsafter allogeneic hematopoietic stem cell transplantation in blood malignancies correlates with relapseSuch reemerging cells can be detected early on using Chimerocyte s technology with limits of detection several orders of magnitude lower than the currentgold standardin chimerism analysisOur technology has the potential to significantly improve early identification of patients with high risk of leukemia relapse post transplant