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Acute Leukemias

Bone marrow WT1 levels at diagnosis, post-induction and post-intensification in adult de novo AML

Leukemia volume 27, pages 2157–2164 (2013)Cite this article

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Abstract

We retrospectively assessed whether normalized bone marrow WT1 levels could be used for risk stratification in a consecutive series of 584 acute myeloid leukemia (AML) patients. A cutoff value of 5065 copies at diagnosis identified two prognostic groups (overall survival (OS): 44±3 vs 36±3%, P=0.023; leukemia-free survival (LFS): 47±3 vs 36±4%, P=0.038; and cumulative incidence of relapse (CIR): 37±3 vs 47±4%, P=:0.043). Three groups were identified on the basis of WT1 levels post-induction: Group 0 (WT1 between 0 and 17.5 copies, 134 patients, OS: 59±4%, LFS:59±4% and CIR: 26±4%); Group 1 (WT1 between 17.6 and 170.5 copies, 160 patients, OS: 48±5%, LFS:41±4% and CIR: 45±4%); and Group 2 (WT1 >170.5 copies, 71 patients, OS: 23±6%, LFS: 19±7% and CIR: 68±8%) (P<0.001). Post-intensification samples distinguished three groups: patients with WT1 >100 copies (47 patients, 16%); an intermediate group of patients with WT1 between 10 and 100 copies (148 patients, 52%); and a third group with WT1 <10 copies (92 patients, 32%). Outcomes differed significantly in terms of OS (30±7%, 59±4%, 72±5%), LFS (24±7%, 46±4%, 65±5%) and relapse probability (CIR 72±7%, 45±4%, 25±5%), all P<0.001. WT1 levels in bone marrow assayed using the standardized ELN method provide relevant prognostic information in de novo AML.

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Acknowledgements

This work was supported by the following grants: Fundación Mutua Madrileña to JN 08/FMMA, Fondo de Investigaciones Sanitarias (FIS) PI 10/0173 and ISCIII PI052312, PI 080672, RD06/0020/0101 and EC07/90065, 2009-SGR-168 from Plà de Recerca de Catalunya, Marató de TV3 (100830/31/32) and a grant from Fundació Cellex, Spain. We are grateful to the CETLAM participating hospitals and to all the European Leukemia Net members (Workpackage 12, MRD).

Author Contributions

JN designed the study, analyzed the data and wrote the paper. MH analyzed the data and wrote the manuscript. MC, EB, CE, JE, MT, RD, OS, MPQLL, AG, JB, IH, JMMT, ALl, JMR, DG, AA and SB analyzed the data. JS designed the study and wrote the paper.

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Author notes

  1. A Llorente: Deceased

Authors and Affiliations

  1. Laboratori d́Hematologia, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain

    J F Nomdedéu, M Carricondo, E Bussaglia, C Estivill & A Aventin

  2. Universitat de Barcelona, Barcelona, Spain

    M Hoyos

  3. Hematology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    M Hoyos, S Brunet & J Sierra

  4. Hematology Department, Hospital Clínic, Barcelona, Spain

    J Esteve

  5. Hematology Department, Hospital Clínic, Valencia, Spain

    M Tormo

  6. Hematology Department, ICO Hospitalet, ĹHospitalet de Llobregat, Spain

    R Duarte

  7. Hematology Department, Hospital de la Vall d́Hebron, Barcelona, Spain

    O Salamero

  8. Hematology Department, Hospital Virgen de la Victoria, Malaga, Spain

    M P Q de Llano

  9. Hematology Department, Hospital Arnau de Vilanova, Lleida, Spain

    A García

  10. Hematology Department, Hospital de Son Llatzer, Palma de Mallorca, Spain

    J Bargay

  11. Hematology Department, Hospital Morales Meseguer, Murcia, Spain

    I Heras

  12. Hematology Department, Hospital de la Mutua de Terrassa, Terrassa, Spain

    J M Martí-Tutusaus

  13. Hematology Department, Hospital Joan XXIII, Tarragona, Spain

    A Llorente

  14. Hematology Department, ICO Badalona, Badalona, Spain

    J M Ribera

  15. Hematology Department, ICO Girona, Girona, Spain

    D Gallardo

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Correspondence to J F Nomdedéu.

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Additional information

These results were partially presented at the 54th Annual Meeting of the American Society of Hematology, 8–11 December 2012, Atlanta.

Supplementary Information accompanies this paper on the Leukemia website

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Nomdedéu, J., Hoyos, M., Carricondo, M. et al. Bone marrow WT1 levels at diagnosis, post-induction and post-intensification in adult de novo AML. Leukemia 27, 2157–2164 (2013). https://doi.org/10.1038/leu.2013.111

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