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Peripheral blood WT1 expression predicts relapse in AML patients undergoing allogeneic stem cell transplantation.

Malagola M, Skert C, Ruggeri G, Turra A, Ribolla R, Cancelli V, Cattina F, Alghisi E, Bernardi S, Perucca S, Di Palma A, Borlenghi E, Pagani C, Rossi G, Caimi L, Russo D - Biomed Res Int (2014)

Bottom Line: Eight out of 11 (73%) patients with a pre-allo-SCT PB-WT1 ≥ 5 and 4/13 (31%) patients with a pre-allo-SCT PB-WT1 < 5 relapsed, respectively (P = 0.04).Patients with pretransplant PB-WT1 < 5 had significantly better 2-year OS and LFS than patients with a PB-WT1 ≥ 5 (81% versus 0% and 63% versus 20%) (P = 0.02).Our data suggest the usefulness of WT1 monitoring from PB to predict the relapse in allotransplanted AML patients and to modulate the intensity of conditioning and/or the posttransplant immunosuppression in an attempt to reduce the posttransplant relapse risk.

View Article: PubMed Central - PubMed

Affiliation: Unit of Blood Disease and Stem Cell Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.

ABSTRACT
To evaluate if WT1 expression may predict relapse after allo-SCT, we analyzed WT1 levels on peripheral blood (PB) and bone marrow (BM) before and after allo-SCT in 24 AML patients with WT1 overexpression at diagnosis. Five copies of WT1/ABL × 10(4) from PB were identified as the threshold value that correlated with relapse after allo-SCT. The same correlation was not identified when WT1 expression was assessed from bone marrow (BM). Eight out of 11 (73%) patients with a pre-allo-SCT PB-WT1 ≥ 5 and 4/13 (31%) patients with a pre-allo-SCT PB-WT1 < 5 relapsed, respectively (P = 0.04). The incidence of relapse was higher in patients with PB-WT1 ≥ 5 measured after allo-SCT, at the 3rd (56% versus 38%; P = 0.43) and at the 6th month (71% versus 20%; P = 0.03). Patients with pretransplant PB-WT1 < 5 had significantly better 2-year OS and LFS than patients with a PB-WT1 ≥ 5 (81% versus 0% and 63% versus 20%) (P = 0.02). Our data suggest the usefulness of WT1 monitoring from PB to predict the relapse in allotransplanted AML patients and to modulate the intensity of conditioning and/or the posttransplant immunosuppression in an attempt to reduce the posttransplant relapse risk.

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(a) OS of the 24 AML patients according to PB-WT1 level before allo-SCT. (b) LFS of the 24 AML patients according to PB-WT1 level before allo-SCT.
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fig1: (a) OS of the 24 AML patients according to PB-WT1 level before allo-SCT. (b) LFS of the 24 AML patients according to PB-WT1 level before allo-SCT.

Mentions: The median follow-up after transplantation is 12 months (range: 2–46). The OS and the LFS according to pretransplant PB-WT1 levels are reported in Figures 1(a) and 1(b). Patients with pretransplant PB-WT1 < 5 had a significantly better OS than patients with a PB-WT1 ≥ 5 at 1 year (81% (95% CI 57–100) versus 60% (95% CI 30–90)), at 2 years (81% (95% CI 57–100), versus 0%), and at 3 years (54% (95% CI 8–100) versus 0%) (P = 0.03) (Figure 1(a)). Similarly, the LFS of patients with pretransplant PB-WT1 < 5 at 1 year (63% (95% CI 35–92)), 2 years (63% (95% CI 35–92)), and 3 years (32% (95% CI 0–78)) was significantly longer in comparison to LFS of patients with pretransplant PB-WT1 ≥ 5 (20% (95% CI 0–45) at 1 year, 2 years, and 3 years; P = 0.02) (Figure 1(b)).


Peripheral blood WT1 expression predicts relapse in AML patients undergoing allogeneic stem cell transplantation.

Malagola M, Skert C, Ruggeri G, Turra A, Ribolla R, Cancelli V, Cattina F, Alghisi E, Bernardi S, Perucca S, Di Palma A, Borlenghi E, Pagani C, Rossi G, Caimi L, Russo D - Biomed Res Int (2014)

(a) OS of the 24 AML patients according to PB-WT1 level before allo-SCT. (b) LFS of the 24 AML patients according to PB-WT1 level before allo-SCT.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150519&req=5

fig1: (a) OS of the 24 AML patients according to PB-WT1 level before allo-SCT. (b) LFS of the 24 AML patients according to PB-WT1 level before allo-SCT.
Mentions: The median follow-up after transplantation is 12 months (range: 2–46). The OS and the LFS according to pretransplant PB-WT1 levels are reported in Figures 1(a) and 1(b). Patients with pretransplant PB-WT1 < 5 had a significantly better OS than patients with a PB-WT1 ≥ 5 at 1 year (81% (95% CI 57–100) versus 60% (95% CI 30–90)), at 2 years (81% (95% CI 57–100), versus 0%), and at 3 years (54% (95% CI 8–100) versus 0%) (P = 0.03) (Figure 1(a)). Similarly, the LFS of patients with pretransplant PB-WT1 < 5 at 1 year (63% (95% CI 35–92)), 2 years (63% (95% CI 35–92)), and 3 years (32% (95% CI 0–78)) was significantly longer in comparison to LFS of patients with pretransplant PB-WT1 ≥ 5 (20% (95% CI 0–45) at 1 year, 2 years, and 3 years; P = 0.02) (Figure 1(b)).

Bottom Line: Eight out of 11 (73%) patients with a pre-allo-SCT PB-WT1 ≥ 5 and 4/13 (31%) patients with a pre-allo-SCT PB-WT1 < 5 relapsed, respectively (P = 0.04).Patients with pretransplant PB-WT1 < 5 had significantly better 2-year OS and LFS than patients with a PB-WT1 ≥ 5 (81% versus 0% and 63% versus 20%) (P = 0.02).Our data suggest the usefulness of WT1 monitoring from PB to predict the relapse in allotransplanted AML patients and to modulate the intensity of conditioning and/or the posttransplant immunosuppression in an attempt to reduce the posttransplant relapse risk.

View Article: PubMed Central - PubMed

Affiliation: Unit of Blood Disease and Stem Cell Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.

ABSTRACT
To evaluate if WT1 expression may predict relapse after allo-SCT, we analyzed WT1 levels on peripheral blood (PB) and bone marrow (BM) before and after allo-SCT in 24 AML patients with WT1 overexpression at diagnosis. Five copies of WT1/ABL × 10(4) from PB were identified as the threshold value that correlated with relapse after allo-SCT. The same correlation was not identified when WT1 expression was assessed from bone marrow (BM). Eight out of 11 (73%) patients with a pre-allo-SCT PB-WT1 ≥ 5 and 4/13 (31%) patients with a pre-allo-SCT PB-WT1 < 5 relapsed, respectively (P = 0.04). The incidence of relapse was higher in patients with PB-WT1 ≥ 5 measured after allo-SCT, at the 3rd (56% versus 38%; P = 0.43) and at the 6th month (71% versus 20%; P = 0.03). Patients with pretransplant PB-WT1 < 5 had significantly better 2-year OS and LFS than patients with a PB-WT1 ≥ 5 (81% versus 0% and 63% versus 20%) (P = 0.02). Our data suggest the usefulness of WT1 monitoring from PB to predict the relapse in allotransplanted AML patients and to modulate the intensity of conditioning and/or the posttransplant immunosuppression in an attempt to reduce the posttransplant relapse risk.

Show MeSH
Related in: MedlinePlus