Leukaemia relapse after allogeneic transplants for acute myeloid leukaemia: predictive role of WT1 expression. (7th January 2013)

• Record Type: Journal Article
• Authors: Pozzi, Sarah; Geroldi, Simona; Tedone, Elisabetta; Luchetti, Silvia; Grasso, Raffaella; Colombo, Nicoletta; Di Grazia, Carmen; Lamparelli, Teresa; Gualandi, Francesca; Ibatici, Adalberto; Bregante, Stefania; Van, Maria Teresa; Raiola, Anna Maria; Dominietto, Alida; Varaldo, Riccardo; Signori, Alessio; Bacigalupo, Andrea
• Is Part Of: British journal of haematology. Volume 160:Number 4(2013:Feb.)
• Page Start: 503
• Page End: 509
• Publication Date: 2013-01-07
• Subjects: Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.12181
• Languages: English
• ISSNs: 0007-1048

Abstract

<abstract abstract-type="main" id="bjh12181-abs-0001"> <title>Summary</title> <p>We assessed <italic>WT1</italic> expression (expressed as messenger copies/10<sup>4</sup><italic>ABL1</italic>) from marrow cells of 122 patients with acute myeloid leukaemia (AML), before and after an unmanipulated allogeneic haemopoietic stem cell transplant (HSCT). The median age was 44 years (15–69), 59% were in first remission, 74% received a myeloablative conditioning regimen and the median follow up was 865 d (34–2833). Relapse was higher in 67 patients with <italic>WT1</italic> expression, at any time post‐HSCT, exceeding 100 copies (54%), as compared to 16%, for 55 patients with post‐HSCT <italic>WT1</italic> expression <100 copies (<italic>P </italic>< 0·0001). Similarly, actuarial 5‐year survival (OS) was 40% vs. 63%, respectively (<italic>P </italic>= 0·03). In multivariate Cox analysis, <italic>WT1</italic> expression post‐HSCT was the strongest predictor of relapse (Hazard Ratio [HR] 4·5, <italic>P </italic>= 0·0001), independent of disease phase (HR 2·3, <italic>P </italic>= 0·002). Donor lymphocyte infusions (DLI) were given to 17 patients because of increasing <italic>WT1</italic> levels: their OS was 44%, vs. 14% for 21 patients with increasing <italic>WT1</italic> expression who did not receive DLI (<italic>P </italic>= 0·004). In conclusion, <italic>WT1</italic> expression post‐HSCT is a strong predictor of leukaemia relapse and survival in AML;<italic> WT1</italic> may be used as a marker for early interventional therapy.</p> </abstract>