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Chronic Myeloid Leukemia

Poor correlation of kinetics between BCR-ABL and WT1 transcript levels after allogeneic stem cell transplantation

Bone Marrow Transplantation volume 33, pages 47–52 (2004)Cite this article

Summary:

After allogeneic stem cell transplantation (SCT), we evaluated the use of the Wilms’ tumor gene (WT1) as a minimal residual disease (MRD) marker in 32 patients (28 chronic myeloid leukemia, three acute lymphoblastic leukemia and one acute myeloid leukemia). All patients expressed BCR-ABL and the kinetics of WT1 were compared with those of BCR-ABL using real-time quantitative PCR. WT1 expression was seen in the peripheral blood (PB) of healthy controls with a median expression level of 7 × 10−5 (WT1/ABL ratio). The corresponding values for BCR-ABL-negative and BCR-ABL-positive patient samples were 1 × 10−4 and 1.6 × 10−4, respectively. Kinetic studies in individual patients showed that WT1 and BCR-ABL levels usually did not copy each other. In four out of six patients who relapsed, an increase in WT1 from the background level (10−4) was observed only at the time of or after relapse, and in two patients increasing WT1 levels were observed before the relapse. In addition, the WT1 values found at the time of relapse were only two logs higher than the background level, indicating a sensitivity of 10−2. In conclusion, there is a constitutive low expression of WT1 in normal hematopoietic cells. The sensitivity and ability of WT1 to predict a relapse were poor in this study.

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Acknowledgements

We thank the staff at the Center for Allogeneic Stem Cell Transplantation and the Departments of Pediatrics and Hematology for excellent and skilful patient care. We also thank Dr Albert Bekassy for the help with some of the patient data. This study was supported by grants from the Swedish Cancer Society (0070-B99-13XAC), the Children's Cancer Foundation (2000/067), the Swedish Medical Research Council (K2000-06X-05971-20A), the Cancer Society in Stockholm and the Tobias Foundation.

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  1. Department of Clinical Immunology, Center for Allogeneic Stem Cell Transplantation (CAST), Karolinska Institutet at Huddinge University Hospital, Stockholm, Sweden

    M Uzunel & O Ringdén

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  1. M Uzunel
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Correspondence to M Uzunel.

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Uzunel, M., Ringdén, O. Poor correlation of kinetics between BCR-ABL and WT1 transcript levels after allogeneic stem cell transplantation. Bone Marrow Transplant 33, 47–52 (2004). https://doi.org/10.1038/sj.bmt.1704296

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