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Acute Leukemia

Impact of Wilms' tumor 1 expression on outcome of patients undergoing allogeneic stem cell transplantation for AML

Bone Marrow Transplantation volume 52, pages 539–543 (2017)Cite this article

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Abstract

The monitoring of the minimal residual disease by Wilms' tumor 1 expression (MRDWT1) is a standardized test, which can be used in over 80% of patients with AML. To investigate the prognostic value of MRDWT1 in patients undergoing allogeneic stem cell transplantation (allo-SCT) for AML, MRDWT1 was monitored 3 months after transplantation in 139 patients. MRDWT1 positivity did not lead to any therapeutic intervention. Median follow-up was 39.3 (6.4–99.8) months. Patients with positive MRDWT1 at 3 months experienced more often post-transplant relapse (27/30, 90%) than those with negative MRDWT1 (16/109, 14.7%) (P<0.0001). Similarly, a shorter 3-year event-free survival (EFS) was observed in MRDWT1-positive patients (10% vs 72.3% in MRDWT1-negative patients, P<0.0001). The correlation between relapse and MRDWT1 was stronger in blood than in bone marrow samples. Multivariate analysis confirmed the detrimental role of 3-month positive MRDWT1 for relapse (hazard ratio (HR): 15.42; 95% confidence interval (CI): 7.53–31.59; P<0.0001) and EFS (HR: 10.71; 95% CI: 5.41–21.21; P<0.0001). Interestingly, 3-month chimerism was less predictive of relapse than positive MRDWT1. In conclusion, our results demonstrate the usefulness of peripheral blood MRDWT1 monitoring in identifying very high-risk patients, who could benefit from an early preemptive treatment, and those who do not need such an intervention.

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Acknowledgements

We thank all of the team members and nursing staff for providing our patients with high-quality care. We are also grateful to the association Capucine for their help in our research.

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Authors and Affiliations

  1. Department of Hematology and Bone Marrow Transplantation, CHRU de Lille, Lille, France

    R Duléry, J Gauthier, V Coiteux, L Magro, B Quesnel & I Yakoub-Agha

  2. University of Lille Nord de France, Lille, France

    R Duléry, O Nibourel, J Gauthier, V Elsermans, H Behal, V Coiteux, L Magro, A Renneville, A Marceau, T Boyer, B Quesnel, C Preudhomme, A Duhamel & I Yakoub-Agha

  3. Inserm, UMRs 837, Team 3, Cancer Research Institute of Lille, Lille, France

    R Duléry, O Nibourel, A Renneville, A Marceau, T Boyer, B Quesnel & C Preudhomme

  4. Laboratory of Hematology, Biology and Pathology Center, CHRU of Lille, Lille, France

    O Nibourel, A Renneville, A Marceau, T Boyer & C Preudhomme

  5. Laboratory of Immunology, Biology and Pathology Center, CHRU of Lille, Lille, France

    V Elsermans & A Duhamel

  6. Department of Biostatistics, CHRU Lille, Lille, France

    H Behal

  7. LIRC U995, Lille, France

    I Yakoub-Agha

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  1. R Duléry
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Correspondence to I Yakoub-Agha.

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Additional information

First presented at the 2014 Annual Meeting of the French Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) (Best Oral Presentation Award).

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Duléry, R., Nibourel, O., Gauthier, J. et al. Impact of Wilms' tumor 1 expression on outcome of patients undergoing allogeneic stem cell transplantation for AML. Bone Marrow Transplant 52, 539–543 (2017). https://doi.org/10.1038/bmt.2016.318

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  • DOI: https://doi.org/10.1038/bmt.2016.318

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