WT1-guided pre-emptive therapy after allogeneic hematopoietic stem cell transplantation in patients with acute myeloid leukemia

Measurable residual disease (MRD)-guided pre-emptive therapies are now widely used to prevent post-transplant hematological relapse in patients with acute myeloid leukemia (AML). This single-center retrospective study aimed to clarify the significance of pre-emptive treatment based on Wilms’ tumor g...

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Published inInternational journal of hematology Vol. 120; no. 3; pp. 337 - 346
Main Authors Arai, Shota, Tachibana, Takayoshi, Izumi, Akihiko, Takeda, Takaaki, Tamai, Yotaro, Sato, Shuku, Hashimoto, Chizuko, Fujimaki, Katsumichi, Ishii, Ryuji, Kabasawa, Noriyuki, Hirasawa, Akira, Inoue, Yasuyuki, Tanaka, Masatsugu, Suzuki, Takahiro, Nakajima, Hideaki
Format Journal Article
LanguageEnglish
Published Singapore Springer Nature Singapore 01.09.2024
Springer Nature B.V
Subjects
Acute myeloid leukemia
Adolescent
Adult
Aged
Allografts
Chemotherapy
Cytarabine
Female
Hematology
Hematopoietic Stem Cell Transplantation
Hematopoietic stem cells
Humans
Leukemia
Leukemia, Myeloid, Acute - therapy
Male
Medicine
Medicine & Public Health
Middle Aged
mRNA
Neoplasm, Residual
Oncology
Original Article
Retrospective Studies
Stem cell transplantation
Stem cells
Survival
Transplantation
Transplantation, Homologous
WT1 Proteins - genetics
Young Adult
Pre-emptive therapy
Acute myeloblastic leukemia
Disease relapse
WT1
Online AccessGet full text

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Abstract Measurable residual disease (MRD)-guided pre-emptive therapies are now widely used to prevent post-transplant hematological relapse in patients with acute myeloid leukemia (AML). This single-center retrospective study aimed to clarify the significance of pre-emptive treatment based on Wilms’ tumor gene-1 mRNA (WT1) monitoring for MRD in patients with AML who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). Patients with AML who received chemotherapy for hematological relapse or WT1 increase after allo-HSCT were eligible for inclusion. From January 2017 to June 2022, 30 patients with a median age of 57 (16–70) years were included and stratified into two groups: 10 with WT1 increase and 20 with hematological relapse. The median times from HCT to WT1 increase or hematological relapse were 309 days (range: 48–985) or 242 days (range: 67–1116), respectively. Less intensive chemotherapy using azacitidine or cytarabine was selected for all patients with WT1 increase and 12 (60%) with hematological relapse. The 1-year overall survival and event-free survival rates for WT1 increase and hematological relapse were 70% vs. 44% ( P  = 0.024) and 70% vs. 29% ( P  = 0.029), respectively. These real-world data suggest that WT1-guided pre-emptive therapy may be superior to therapy after hematological relapse in patients with AML who have undergone allo-HSCT.
AbstractList Measurable residual disease (MRD)-guided pre-emptive therapies are now widely used to prevent post-transplant hematological relapse in patients with acute myeloid leukemia (AML). This single-center retrospective study aimed to clarify the significance of pre-emptive treatment based on Wilms’ tumor gene-1 mRNA (WT1) monitoring for MRD in patients with AML who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). Patients with AML who received chemotherapy for hematological relapse or WT1 increase after allo-HSCT were eligible for inclusion. From January 2017 to June 2022, 30 patients with a median age of 57 (16–70) years were included and stratified into two groups: 10 with WT1 increase and 20 with hematological relapse. The median times from HCT to WT1 increase or hematological relapse were 309 days (range: 48–985) or 242 days (range: 67–1116), respectively. Less intensive chemotherapy using azacitidine or cytarabine was selected for all patients with WT1 increase and 12 (60%) with hematological relapse. The 1-year overall survival and event-free survival rates for WT1 increase and hematological relapse were 70% vs. 44% ( P  = 0.024) and 70% vs. 29% ( P  = 0.029), respectively. These real-world data suggest that WT1-guided pre-emptive therapy may be superior to therapy after hematological relapse in patients with AML who have undergone allo-HSCT.
Measurable residual disease (MRD)-guided pre-emptive therapies are now widely used to prevent post-transplant hematological relapse in patients with acute myeloid leukemia (AML). This single-center retrospective study aimed to clarify the significance of pre-emptive treatment based on Wilms' tumor gene-1 mRNA (WT1) monitoring for MRD in patients with AML who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). Patients with AML who received chemotherapy for hematological relapse or WT1 increase after allo-HSCT were eligible for inclusion. From January 2017 to June 2022, 30 patients with a median age of 57 (16-70) years were included and stratified into two groups: 10 with WT1 increase and 20 with hematological relapse. The median times from HCT to WT1 increase or hematological relapse were 309 days (range: 48-985) or 242 days (range: 67-1116), respectively. Less intensive chemotherapy using azacitidine or cytarabine was selected for all patients with WT1 increase and 12 (60%) with hematological relapse. The 1-year overall survival and event-free survival rates for WT1 increase and hematological relapse were 70% vs. 44% (P = 0.024) and 70% vs. 29% (P = 0.029), respectively. These real-world data suggest that WT1-guided pre-emptive therapy may be superior to therapy after hematological relapse in patients with AML who have undergone allo-HSCT.
Measurable residual disease (MRD)-guided pre-emptive therapies are now widely used to prevent post-transplant hematological relapse in patients with acute myeloid leukemia (AML). This single-center retrospective study aimed to clarify the significance of pre-emptive treatment based on Wilms’ tumor gene-1 mRNA (WT1) monitoring for MRD in patients with AML who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). Patients with AML who received chemotherapy for hematological relapse or WT1 increase after allo-HSCT were eligible for inclusion. From January 2017 to June 2022, 30 patients with a median age of 57 (16–70) years were included and stratified into two groups: 10 with WT1 increase and 20 with hematological relapse. The median times from HCT to WT1 increase or hematological relapse were 309 days (range: 48–985) or 242 days (range: 67–1116), respectively. Less intensive chemotherapy using azacitidine or cytarabine was selected for all patients with WT1 increase and 12 (60%) with hematological relapse. The 1-year overall survival and event-free survival rates for WT1 increase and hematological relapse were 70% vs. 44% (P = 0.024) and 70% vs. 29% (P = 0.029), respectively. These real-world data suggest that WT1-guided pre-emptive therapy may be superior to therapy after hematological relapse in patients with AML who have undergone allo-HSCT.
Measurable residual disease (MRD)-guided pre-emptive therapies are now widely used to prevent post-transplant hematological relapse in patients with acute myeloid leukemia (AML). This single-center retrospective study aimed to clarify the significance of pre-emptive treatment based on Wilms' tumor gene-1 mRNA (WT1) monitoring for MRD in patients with AML who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). Patients with AML who received chemotherapy for hematological relapse or WT1 increase after allo-HSCT were eligible for inclusion. From January 2017 to June 2022, 30 patients with a median age of 57 (16-70) years were included and stratified into two groups: 10 with WT1 increase and 20 with hematological relapse. The median times from HCT to WT1 increase or hematological relapse were 309 days (range: 48-985) or 242 days (range: 67-1116), respectively. Less intensive chemotherapy using azacitidine or cytarabine was selected for all patients with WT1 increase and 12 (60%) with hematological relapse. The 1-year overall survival and event-free survival rates for WT1 increase and hematological relapse were 70% vs. 44% (P = 0.024) and 70% vs. 29% (P = 0.029), respectively. These real-world data suggest that WT1-guided pre-emptive therapy may be superior to therapy after hematological relapse in patients with AML who have undergone allo-HSCT.Measurable residual disease (MRD)-guided pre-emptive therapies are now widely used to prevent post-transplant hematological relapse in patients with acute myeloid leukemia (AML). This single-center retrospective study aimed to clarify the significance of pre-emptive treatment based on Wilms' tumor gene-1 mRNA (WT1) monitoring for MRD in patients with AML who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). Patients with AML who received chemotherapy for hematological relapse or WT1 increase after allo-HSCT were eligible for inclusion. From January 2017 to June 2022, 30 patients with a median age of 57 (16-70) years were included and stratified into two groups: 10 with WT1 increase and 20 with hematological relapse. The median times from HCT to WT1 increase or hematological relapse were 309 days (range: 48-985) or 242 days (range: 67-1116), respectively. Less intensive chemotherapy using azacitidine or cytarabine was selected for all patients with WT1 increase and 12 (60%) with hematological relapse. The 1-year overall survival and event-free survival rates for WT1 increase and hematological relapse were 70% vs. 44% (P = 0.024) and 70% vs. 29% (P = 0.029), respectively. These real-world data suggest that WT1-guided pre-emptive therapy may be superior to therapy after hematological relapse in patients with AML who have undergone allo-HSCT.
Author Inoue, Yasuyuki
Sato, Shuku
Arai, Shota
Hashimoto, Chizuko
Hirasawa, Akira
Ishii, Ryuji
Tanaka, Masatsugu
Suzuki, Takahiro
Kabasawa, Noriyuki
Nakajima, Hideaki
Tachibana, Takayoshi
Takeda, Takaaki
Izumi, Akihiko
Tamai, Yotaro
Fujimaki, Katsumichi
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  surname: Arai
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  orcidid: 0000-0002-7780-4459
  surname: Tachibana
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  email: tcbn@kcch.jp
  organization: Department of Hematology, Kanagawa Cancer Center
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  givenname: Akihiko
  surname: Izumi
  fullname: Izumi, Akihiko
  organization: Department of Hematology, Kanagawa Cancer Center
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  givenname: Takaaki
  surname: Takeda
  fullname: Takeda, Takaaki
  organization: Department of Hematology, Kanagawa Cancer Center
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  surname: Tamai
  fullname: Tamai, Yotaro
  organization: Division of Hematology, Shonan Kamakura General Hospital
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  organization: Department of Hematology, Fujisawa City Hospital
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  organization: Department of Hematology, Japan Community Health Care Organization Sagamino Hospital
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  givenname: Yasuyuki
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  fullname: Inoue, Yasuyuki
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  givenname: Masatsugu
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  organization: Department of Hematology, Kitasato University School of Medicine
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  givenname: Hideaki
  surname: Nakajima
  fullname: Nakajima, Hideaki
  organization: Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine
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Acute myeloblastic leukemia
Disease relapse
WT1
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Snippet Measurable residual disease (MRD)-guided pre-emptive therapies are now widely used to prevent post-transplant hematological relapse in patients with acute...
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SubjectTerms Acute myeloid leukemia
Adolescent
Adult
Aged
Allografts
Chemotherapy
Cytarabine
Female
Hematology
Hematopoietic Stem Cell Transplantation
Hematopoietic stem cells
Humans
Leukemia
Leukemia, Myeloid, Acute - therapy
Male
Medicine
Medicine & Public Health
Middle Aged
mRNA
Neoplasm, Residual
Oncology
Original Article
Retrospective Studies
Stem cell transplantation
Stem cells
Survival
Transplantation
Transplantation, Homologous
WT1 Proteins - genetics
Young Adult
Title WT1-guided pre-emptive therapy after allogeneic hematopoietic stem cell transplantation in patients with acute myeloid leukemia
URI https://link.springer.com/article/10.1007/s12185-024-03795-z
https://www.ncbi.nlm.nih.gov/pubmed/38795248
https://www.proquest.com/docview/3098437435
https://www.proquest.com/docview/3060372813
Volume 120
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