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Early detection of WT1 measurable residual disease identifies high-risk patients, independent of transplantation in AML
| Content Provider | Scilit |
|---|---|
| Author | Lambert, Juliette Lambert, Jerome Thomas, Xavier Marceau-Renaut, Alice Micol, Jean-Baptiste Renneville, Aline Clappier, Emmanuelle Hayette, Sandrine Récher, Christian Raffoux, Emmanuel Pigneux, Arnaud Berthon, Celine Terré, Christine Celli-Lebras, Karine Castaigne, Sylvie Boissel, Nicolas Rousselot, Philippe Preudhomme, Claude Dombret, Hervé Duployez, Nicolas |
| Copyright Year | 2021 |
| Description | WT1 overexpression is frequently identified in acute myeloid leukemia (AML) and has been reported as a potential marker for measurable residual disease (MRD) monitoring. Here, we evaluated the value of post-induction WT1 MRD level as a prognostic factor, as well as the interaction between post-induction WT1 MRD response and the effect of allogeneic stem cell transplantation (allo-SCT) in first complete remission (CR). In the ALFA-0702 trial, AML patients aged 18 to 59 years had a prospective quantification of WT1 MRD. Occurrence of a WT1 MRD ratio >2.5% in bone marrow or >0.5% in peripheral blood was defined as $MRD^{high}$, while ratio under these thresholds was defined as $MRD^{low}$. The prognostic value of MRD after induction chemotherapy was assessed in 314 patients in first CR by comparing the risk of relapse, the relapse-free survival (RFS) and the overall survival (OS). Interaction between MRD response and allo-SCT effect was evaluated in patients by comparing the influence of allo-SCT on the outcomes of patients with $MRD^{high}$ and $MRD^{low}$. We showed that $MRD^{high}$ patients after induction had a higher risk of relapse and a shorter RFS and OS. MRD response remained of strong prognostic value in the subset of 225 patients with intermediate/unfavorable-risk AML, eligible for allo-SCT, since $MRD^{high}$ patients had a significantly higher risk of relapse resulting in worse RFS and OS. Effect of allo-SCT was higher in $MRD^{low}$ patients than in $MRD^{high}$ patients but not statistically different. Early WT1 MRD response highlight a population of high-risk patients in need of additional therapies. |
| Related Links | https://ashpublications.org/bloodadvances/article-pdf/doi/10.1182/bloodadvances.2021004322/1827413/bloodadvances.2021004322.pdf |
| Ending Page | 5268 |
| Page Count | 11 |
| Starting Page | 5258 |
| DOI | 10.1182/bloodadvances.2021004322 |
| Journal | Blood advances |
| Issue Number | 23 |
| Volume Number | 5 |
| Language | English |
| Publisher | American Society of Hematology |
| Publisher Date | 2021-12-08 |
| Access Restriction | Open |
| Subject Keyword | Hematology Bone Marrow Wt1 Aml Mrd Prognostic Value High Risk Patients Survival Journal: Blood advances (Vol- 136, Issue- 23) |
| Content Type | Text |
| Resource Type | Article |
