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Leukaemia relapse after allogeneic transplants for acute myeloid leukaemia: predictive role of WT 1 expression
Author(s) -
Pozzi Sarah,
Geroldi Simona,
Tedone Elisabetta,
Luchetti Silvia,
Grasso Raffaella,
Colombo Nicoletta,
Di Grazia Carmen,
Lamparelli Teresa,
Gualandi Francesca,
Ibatici Adalberto,
Bregante Stefania,
Lint Maria Teresa,
Raiola Anna Maria,
Dominietto Alida,
Varaldo Riccardo,
Signori Alessio,
Bacigalupo Andrea
Publication year - 2013
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.12181
Subject(s) - myeloid leukaemia , medicine , oncology , chronic myeloid leukaemia , myeloid , immunology , expression (computer science) , cancer research , computer science , programming language
Summary We assessed WT 1 expression (expressed as messenger copies/10 4 ABL 1 ) 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 WT 1 expression, at any time post‐ HSCT , exceeding 100 copies (54%), as compared to 16%, for 55 patients with post‐ HSCT WT 1 expression <100 copies ( P < 0·0001). Similarly, actuarial 5‐year survival ( OS ) was 40% vs. 63%, respectively ( P = 0·03). In multivariate Cox analysis, WT 1 expression post‐ HSCT was the strongest predictor of relapse ( H azard R atio [ HR ] 4·5, P = 0·0001), independent of disease phase ( HR 2·3, P = 0·002). Donor lymphocyte infusions ( DLI ) were given to 17 patients because of increasing WT 1 levels: their OS was 44%, vs. 14% for 21 patients with increasing WT 1 expression who did not receive DLI ( P = 0·004). In conclusion, WT 1 expression post‐ HSCT is a strong predictor of leukaemia relapse and survival in AML ; WT 1 may be used as a marker for early interventional therapy.