Clinical Utility of Wilms' Tumor 1 Monitoring in Patients with Myeloid Malignancy and Prior Allogeneic Hematopoietic Stem Cell Transplantation
Clinical Utility of Wilms' Tumor 1 Monitoring in Patients with Myeloid Malignancy and Prior Allogeneic Hematopoietic Stem Cell Transplantation
复制标题
DOI：
10.1016/j.bbmt.2017.06.007
复制
发表时间：
2017-10-01
影响因子：
4.3
通讯作者：
Fukuda, Takahiro
中科院分区：
文献类型：
--
作者：
Ino, Kazuko;Fuji, Shigeo;Fukuda, Takahiro
虽然异基因造血干细胞移植（allo-HSCT）是骨髓恶性肿瘤的标准治疗方法之一，但复发仍然是治愈的主要障碍。通过监测微小残留病（MRD）早期发现复发可能使我们能够先发制人地进行干预，并可能预防明显的复发。Wilms' tumor 1（WTI）作为泛白血病标志物是众所周知的。我们回顾性研究了98例患者（84例急性髓性白血病和14例骨髓增生异常综合征）外周血WTI水平的连续监测。在allo-HSCT时，49例患者（50%）完全缓解。根据WTI水平（500拷贝/μ gRNA）将患者分为3组。根据allo-HSCT前和allo-HSCT后30天和60天的WTI水平，累积复发率（CIR）和总生存期（OS）存在统计学差异。在多变量分析中，异基因造血干细胞移植前和移植后第60天WT 1>500拷贝/μ g RNA和第30天WTI拷贝/μ g RNA与CIR相关。此外，在allo-HSCT后第60天，WTI >500拷贝/μ g RNA仅与更差的OS相关。我们的数据表明，外周血中WTI水平的连续监测可用于MRD监测，并可作为allo-HSCT中血液学复发的预测因子。(C)2017年美国血液和骨髓移植协会。
Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) is 1 of the standard treatments for myeloid malignancy, relapse remains a major obstacle to cure. Early detection of relapse by monitoring of minimal residual disease (MRD) may enable us to intervene pre-emptively and potentially prevent overt relapse. Wilms' tumor 1 (WTI) is well known as a pan-leukemic marker. We retrospectively examined serially monitored WTI levels of peripheral blood in 98 patients (84 with acute myeloid leukemia and 14 with myelodysplastic syndrome). At the time of allo-HSCT, 49 patients (50%) were in complete remission. Patients were divided into 3 groups according to WTI levels (500 copies/mu g.RNA). The cumulative incidence of relapse (CIR) and overall survival (OS) differed statistically according to the WTI levels before allo-HSCT and at days 30 and 60 after allo-HSCT. In multivariate analysis, WT1 >500 copies/mu g RNA before and at day 60 after allo-HSCT and WTI copies/mu g RNA at day 30 were correlated with CIR. Moreover, WTI >500 copies/mu g RNA at day 60 after allo-HSCT was only correlated with worse OS. Our data suggest that serial monitoring of WTI levels in peripheral blood may be useful for MRD monitoring and as a predictor of hematological relapse in allo-HSCT. (C) 2017 American Society for Blood and Marrow Transplantation.