Table 6.

Recommended assessment of chimerism

ChimerismAssessmentInterval
Clinical STR analysis on bone marrow or sorted peripheral blood cells (myeloid and T cells) 1, 3, 6, 12, and 24 months 
Repeat if continued mixed chimerism 
Repeat in the event of return of abnormal hematologic/hemolysis parameters 
Autologous cell engraftment Percent of edited cells (gene editing) All GT patients should be tracked for at least 15 y by mandate 
Vector copy number (average of viral vector per stem cell)  
Hemoglobin analysis for Hb S level Every 3 months × 1 year 
Every 6 months in year 2 
Yearly × 5 years 
As needed subsequently 
Hemolysis parameters, including hemoglobin, absolute reticulocyte count, lactate dehydrogenase, and indirect bilirubin Every 3 months × 1 year 
Every 6 months in year 2 
Yearly × 5 years 
As needed subsequently 
Research Glycophorin A + CD71+ red cell precursor genomic analysis for engraftment128,129  
Functional biomarkers 
Red cell viscosity, RBC elongation index by ektacytometry, and RBC adhesion index 
Specialized cell subtypes, cytokines, and chemokines 
ChimerismAssessmentInterval
Clinical STR analysis on bone marrow or sorted peripheral blood cells (myeloid and T cells) 1, 3, 6, 12, and 24 months 
Repeat if continued mixed chimerism 
Repeat in the event of return of abnormal hematologic/hemolysis parameters 
Autologous cell engraftment Percent of edited cells (gene editing) All GT patients should be tracked for at least 15 y by mandate 
Vector copy number (average of viral vector per stem cell)  
Hemoglobin analysis for Hb S level Every 3 months × 1 year 
Every 6 months in year 2 
Yearly × 5 years 
As needed subsequently 
Hemolysis parameters, including hemoglobin, absolute reticulocyte count, lactate dehydrogenase, and indirect bilirubin Every 3 months × 1 year 
Every 6 months in year 2 
Yearly × 5 years 
As needed subsequently 
Research Glycophorin A + CD71+ red cell precursor genomic analysis for engraftment128,129  
Functional biomarkers 
Red cell viscosity, RBC elongation index by ektacytometry, and RBC adhesion index 
Specialized cell subtypes, cytokines, and chemokines 

Hb S, hemoglobin S; RBC, red blood cell; STR, short tandem repeat.

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