WT1-guided pre-emptive therapy after allogeneic hematopoietic stem cell transplantation in patients with acute myeloid leukemia
Abstract The prognosis of patients with acute myeloid leukemia (AML) relapsing after allogeneic hematopoietic stem cell transplantation (HCT) is poor. Several studies have evaluated the significance of pre-emptive therapies using measurable residual disease (MRD) as a marker of hematological relapse. This single-center retrospective study aimed to clarify the significance of pre-emptive treatment based on Wilms’ tumor gene-1 mRNA (WT1) monitoring as an MRD in allografted patients with AML. The eligibility criteria were patients with AML who received chemotherapy for hematological relapse or WT1 increase after HCT. 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 in the WT1 group and 20 in the 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 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 allografted patients with AML..
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Preprint| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
ResearchSquare.com - (2024) vom: 31. Jan. Zur Gesamtaufnahme - year:2024 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Arai, Shota [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| doi: |
10.21203/rs.3.rs-3743328/v1 |
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| PPN (Katalog-ID): |
XRA042023084 |
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| 520 | |a Abstract The prognosis of patients with acute myeloid leukemia (AML) relapsing after allogeneic hematopoietic stem cell transplantation (HCT) is poor. Several studies have evaluated the significance of pre-emptive therapies using measurable residual disease (MRD) as a marker of hematological relapse. This single-center retrospective study aimed to clarify the significance of pre-emptive treatment based on Wilms’ tumor gene-1 mRNA (WT1) monitoring as an MRD in allografted patients with AML. The eligibility criteria were patients with AML who received chemotherapy for hematological relapse or WT1 increase after HCT. 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 in the WT1 group and 20 in the 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 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 allografted patients with AML. | ||
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