Prognostic impact of pretransplant measurable residual disease assessed by peripheral blood WT1‐mRNA expression in patients with AML and MDS
Objective As peripheral blood (PB) Wilm's Tumor 1 (WT1)‐mRNA expression is established as MRD‐marker during conventional AML chemotherapy, impact of pretransplant WT1 expression remains unclear. Therefore, we aimed to assess prognostic impact of pretransplant WT1 expression on post‐transplant o...
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Veröffentlicht in: | European journal of haematology 2021-08, Vol.107 (2), p.283-292 |
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creator | Rautenberg, Christina Lauseker, Michael Kaivers, Jennifer Jäger, Paul Fischermanns, Carolin Pechtel, Sabrina Haas, Rainer Kobbe, Guido Germing, Ulrich Schroeder, Thomas |
description | Objective
As peripheral blood (PB) Wilm's Tumor 1 (WT1)‐mRNA expression is established as MRD‐marker during conventional AML chemotherapy, impact of pretransplant WT1 expression remains unclear. Therefore, we aimed to assess prognostic impact of pretransplant WT1 expression on post‐transplant outcome in patients with AML/MDS.
Methods
In 64 AML/MDS patients, pretransplant WT1 expression was retrospectively analyzed using a standardized assay offering high sensitivity, specificity, and a validated cut‐off. Patients were divided into three groups determined by pretransplant remission and WT1 expression. Post‐transplant outcome of these groups was compared regarding cumulative incidence of relapse (CIR), relapse‐free (RFS), and overall survival (OS).
Results
Pretransplant forty‐six patients (72%) showed hematologic remission, including 21 (46%) MRD‐negative and 25 (54%) MRD‐positive patients indicated by WT1 expression, while 18 refractory patients (28%) showed active disease. Two‐year estimates of post‐transplant CIR, RFS, and OS were similar in MRD‐positive (61%, 37%, 54%) and refractory patients (70%, 26%, 56%), but significantly inferior compared with MRD‐negative patients (10%, 89%, 90%). After multivariable adjustment, pretransplant MRD negativity measured by WT1 expression retained its prognostic impact on CIR (P = .008), RFS (P = .005), and OS (P = .049).
Conclusions
PB WT1 expression represents a useful method to estimate pretransplant MRD, which is highly predictable for post‐transplant outcome and may help improving peri‐transplant management in AML/MDS patients. |
doi_str_mv | 10.1111/ejh.13664 |
format | Article |
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As peripheral blood (PB) Wilm's Tumor 1 (WT1)‐mRNA expression is established as MRD‐marker during conventional AML chemotherapy, impact of pretransplant WT1 expression remains unclear. Therefore, we aimed to assess prognostic impact of pretransplant WT1 expression on post‐transplant outcome in patients with AML/MDS.
Methods
In 64 AML/MDS patients, pretransplant WT1 expression was retrospectively analyzed using a standardized assay offering high sensitivity, specificity, and a validated cut‐off. Patients were divided into three groups determined by pretransplant remission and WT1 expression. Post‐transplant outcome of these groups was compared regarding cumulative incidence of relapse (CIR), relapse‐free (RFS), and overall survival (OS).
Results
Pretransplant forty‐six patients (72%) showed hematologic remission, including 21 (46%) MRD‐negative and 25 (54%) MRD‐positive patients indicated by WT1 expression, while 18 refractory patients (28%) showed active disease. Two‐year estimates of post‐transplant CIR, RFS, and OS were similar in MRD‐positive (61%, 37%, 54%) and refractory patients (70%, 26%, 56%), but significantly inferior compared with MRD‐negative patients (10%, 89%, 90%). After multivariable adjustment, pretransplant MRD negativity measured by WT1 expression retained its prognostic impact on CIR (P = .008), RFS (P = .005), and OS (P = .049).
Conclusions
PB WT1 expression represents a useful method to estimate pretransplant MRD, which is highly predictable for post‐transplant outcome and may help improving peri‐transplant management in AML/MDS patients.</description><identifier>ISSN: 0902-4441</identifier><identifier>EISSN: 1600-0609</identifier><identifier>DOI: 10.1111/ejh.13664</identifier><identifier>PMID: 33987857</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>acute myeloid leukemia ; Adult ; Aged ; Biomarkers, Tumor ; Blood Cells ; Cell-Free Nucleic Acids ; Chemotherapy ; Female ; Gene Expression ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myeloid, Acute - genetics ; Leukemia, Myeloid, Acute - mortality ; Leukemia, Myeloid, Acute - pathology ; Leukemia, Myeloid, Acute - therapy ; Male ; measurable residual disease ; Middle Aged ; myelodysplastic syndrome ; Myelodysplastic Syndromes - genetics ; Myelodysplastic Syndromes - mortality ; Myelodysplastic Syndromes - pathology ; Myelodysplastic Syndromes - therapy ; Neoplasm, Residual - diagnosis ; Neoplasm, Residual - genetics ; Peripheral blood ; Preoperative Period ; Prognosis ; Recurrence ; relapse ; Remission ; Remission (Medicine) ; Retrospective Studies ; RNA, Messenger ; transplantation ; Transplantation, Homologous ; Treatment Outcome ; WT1 ; WT1 Proteins - genetics ; Young Adult</subject><ispartof>European journal of haematology, 2021-08, Vol.107 (2), p.283-292</ispartof><rights>2021 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2021 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.</rights><rights>2021. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3884-dd0edf0940eb7949331d46f5c1ce1a45f9874f294991ee188e4e2329528172123</citedby><cites>FETCH-LOGICAL-c3884-dd0edf0940eb7949331d46f5c1ce1a45f9874f294991ee188e4e2329528172123</cites><orcidid>0000-0002-0611-1372 ; 0000-0002-6662-7127 ; 0000-0003-3255-721X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fejh.13664$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fejh.13664$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33987857$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rautenberg, Christina</creatorcontrib><creatorcontrib>Lauseker, Michael</creatorcontrib><creatorcontrib>Kaivers, Jennifer</creatorcontrib><creatorcontrib>Jäger, Paul</creatorcontrib><creatorcontrib>Fischermanns, Carolin</creatorcontrib><creatorcontrib>Pechtel, Sabrina</creatorcontrib><creatorcontrib>Haas, Rainer</creatorcontrib><creatorcontrib>Kobbe, Guido</creatorcontrib><creatorcontrib>Germing, Ulrich</creatorcontrib><creatorcontrib>Schroeder, Thomas</creatorcontrib><title>Prognostic impact of pretransplant measurable residual disease assessed by peripheral blood WT1‐mRNA expression in patients with AML and MDS</title><title>European journal of haematology</title><addtitle>Eur J Haematol</addtitle><description>Objective
As peripheral blood (PB) Wilm's Tumor 1 (WT1)‐mRNA expression is established as MRD‐marker during conventional AML chemotherapy, impact of pretransplant WT1 expression remains unclear. Therefore, we aimed to assess prognostic impact of pretransplant WT1 expression on post‐transplant outcome in patients with AML/MDS.
Methods
In 64 AML/MDS patients, pretransplant WT1 expression was retrospectively analyzed using a standardized assay offering high sensitivity, specificity, and a validated cut‐off. Patients were divided into three groups determined by pretransplant remission and WT1 expression. Post‐transplant outcome of these groups was compared regarding cumulative incidence of relapse (CIR), relapse‐free (RFS), and overall survival (OS).
Results
Pretransplant forty‐six patients (72%) showed hematologic remission, including 21 (46%) MRD‐negative and 25 (54%) MRD‐positive patients indicated by WT1 expression, while 18 refractory patients (28%) showed active disease. Two‐year estimates of post‐transplant CIR, RFS, and OS were similar in MRD‐positive (61%, 37%, 54%) and refractory patients (70%, 26%, 56%), but significantly inferior compared with MRD‐negative patients (10%, 89%, 90%). After multivariable adjustment, pretransplant MRD negativity measured by WT1 expression retained its prognostic impact on CIR (P = .008), RFS (P = .005), and OS (P = .049).
Conclusions
PB WT1 expression represents a useful method to estimate pretransplant MRD, which is highly predictable for post‐transplant outcome and may help improving peri‐transplant management in AML/MDS patients.</description><subject>acute myeloid leukemia</subject><subject>Adult</subject><subject>Aged</subject><subject>Biomarkers, Tumor</subject><subject>Blood Cells</subject><subject>Cell-Free Nucleic Acids</subject><subject>Chemotherapy</subject><subject>Female</subject><subject>Gene Expression</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Humans</subject><subject>Leukemia, Myeloid, Acute - genetics</subject><subject>Leukemia, Myeloid, Acute - mortality</subject><subject>Leukemia, Myeloid, Acute - pathology</subject><subject>Leukemia, Myeloid, Acute - therapy</subject><subject>Male</subject><subject>measurable residual disease</subject><subject>Middle Aged</subject><subject>myelodysplastic syndrome</subject><subject>Myelodysplastic Syndromes - genetics</subject><subject>Myelodysplastic Syndromes - mortality</subject><subject>Myelodysplastic Syndromes - pathology</subject><subject>Myelodysplastic Syndromes - therapy</subject><subject>Neoplasm, Residual - diagnosis</subject><subject>Neoplasm, Residual - genetics</subject><subject>Peripheral blood</subject><subject>Preoperative Period</subject><subject>Prognosis</subject><subject>Recurrence</subject><subject>relapse</subject><subject>Remission</subject><subject>Remission (Medicine)</subject><subject>Retrospective Studies</subject><subject>RNA, Messenger</subject><subject>transplantation</subject><subject>Transplantation, Homologous</subject><subject>Treatment Outcome</subject><subject>WT1</subject><subject>WT1 Proteins - genetics</subject><subject>Young Adult</subject><issn>0902-4441</issn><issn>1600-0609</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp1kcFO3DAQhq0KVBbKoS9QWeJCDwHbcRL7uAJaqJYWAVWPkRNPul4lcfAkgr31Cao-I09Sw9IeKnVkaSTPp08z-gl5y9kRj3UMq-URT_NcviIznjOWsJzpLTJjmolESsl3yC7iijEmNC9ek5001apQWTEjP6-C_957HF1NXTeYeqS-oUOAMZgeh9b0I-3A4BRM1QINgM5OpqXWYfwFahAhPkurNR0guGEJIY6r1ntLv93yxx-_uuvPcwoP0YnofE9dTwczOuhHpPduXNL55YKa3tLL05s3ZLsxLcL-S98jXz-c3Z6cJ4svHy9O5oukTpWSibUMbMO0ZFAVWuo05VbmTVbzGriRWRPPk42IE80BuFIgQaRCZ0LxQnCR7pHDjXcI_m4CHMvOYQ1tvBf8hKV4JvNM6Yge_IOu_BT6uF2kpNKMy4JH6v2GqoNHDNCUQ3CdCeuSs_IppDKGVD6HFNl3L8ap6sD-Jf-kEoHjDXDvWlj_31SefTrfKH8DXk6caw</recordid><startdate>202108</startdate><enddate>202108</enddate><creator>Rautenberg, Christina</creator><creator>Lauseker, Michael</creator><creator>Kaivers, Jennifer</creator><creator>Jäger, Paul</creator><creator>Fischermanns, Carolin</creator><creator>Pechtel, Sabrina</creator><creator>Haas, Rainer</creator><creator>Kobbe, Guido</creator><creator>Germing, Ulrich</creator><creator>Schroeder, Thomas</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QG</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0611-1372</orcidid><orcidid>https://orcid.org/0000-0002-6662-7127</orcidid><orcidid>https://orcid.org/0000-0003-3255-721X</orcidid></search><sort><creationdate>202108</creationdate><title>Prognostic impact of pretransplant measurable residual disease assessed by peripheral blood WT1‐mRNA expression in patients with AML and MDS</title><author>Rautenberg, Christina ; Lauseker, Michael ; Kaivers, Jennifer ; Jäger, Paul ; Fischermanns, Carolin ; Pechtel, Sabrina ; Haas, Rainer ; Kobbe, Guido ; Germing, Ulrich ; Schroeder, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3884-dd0edf0940eb7949331d46f5c1ce1a45f9874f294991ee188e4e2329528172123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>acute myeloid leukemia</topic><topic>Adult</topic><topic>Aged</topic><topic>Biomarkers, Tumor</topic><topic>Blood Cells</topic><topic>Cell-Free Nucleic Acids</topic><topic>Chemotherapy</topic><topic>Female</topic><topic>Gene Expression</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Humans</topic><topic>Leukemia, Myeloid, Acute - genetics</topic><topic>Leukemia, Myeloid, Acute - mortality</topic><topic>Leukemia, Myeloid, Acute - pathology</topic><topic>Leukemia, Myeloid, Acute - therapy</topic><topic>Male</topic><topic>measurable residual disease</topic><topic>Middle Aged</topic><topic>myelodysplastic syndrome</topic><topic>Myelodysplastic Syndromes - genetics</topic><topic>Myelodysplastic Syndromes - mortality</topic><topic>Myelodysplastic Syndromes - pathology</topic><topic>Myelodysplastic Syndromes - therapy</topic><topic>Neoplasm, Residual - diagnosis</topic><topic>Neoplasm, Residual - genetics</topic><topic>Peripheral blood</topic><topic>Preoperative Period</topic><topic>Prognosis</topic><topic>Recurrence</topic><topic>relapse</topic><topic>Remission</topic><topic>Remission (Medicine)</topic><topic>Retrospective Studies</topic><topic>RNA, Messenger</topic><topic>transplantation</topic><topic>Transplantation, Homologous</topic><topic>Treatment Outcome</topic><topic>WT1</topic><topic>WT1 Proteins - genetics</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rautenberg, Christina</creatorcontrib><creatorcontrib>Lauseker, Michael</creatorcontrib><creatorcontrib>Kaivers, Jennifer</creatorcontrib><creatorcontrib>Jäger, Paul</creatorcontrib><creatorcontrib>Fischermanns, Carolin</creatorcontrib><creatorcontrib>Pechtel, Sabrina</creatorcontrib><creatorcontrib>Haas, Rainer</creatorcontrib><creatorcontrib>Kobbe, Guido</creatorcontrib><creatorcontrib>Germing, Ulrich</creatorcontrib><creatorcontrib>Schroeder, Thomas</creatorcontrib><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Animal Behavior Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of haematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rautenberg, Christina</au><au>Lauseker, Michael</au><au>Kaivers, Jennifer</au><au>Jäger, Paul</au><au>Fischermanns, Carolin</au><au>Pechtel, Sabrina</au><au>Haas, Rainer</au><au>Kobbe, Guido</au><au>Germing, Ulrich</au><au>Schroeder, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic impact of pretransplant measurable residual disease assessed by peripheral blood WT1‐mRNA expression in patients with AML and MDS</atitle><jtitle>European journal of haematology</jtitle><addtitle>Eur J Haematol</addtitle><date>2021-08</date><risdate>2021</risdate><volume>107</volume><issue>2</issue><spage>283</spage><epage>292</epage><pages>283-292</pages><issn>0902-4441</issn><eissn>1600-0609</eissn><abstract>Objective
As peripheral blood (PB) Wilm's Tumor 1 (WT1)‐mRNA expression is established as MRD‐marker during conventional AML chemotherapy, impact of pretransplant WT1 expression remains unclear. Therefore, we aimed to assess prognostic impact of pretransplant WT1 expression on post‐transplant outcome in patients with AML/MDS.
Methods
In 64 AML/MDS patients, pretransplant WT1 expression was retrospectively analyzed using a standardized assay offering high sensitivity, specificity, and a validated cut‐off. Patients were divided into three groups determined by pretransplant remission and WT1 expression. Post‐transplant outcome of these groups was compared regarding cumulative incidence of relapse (CIR), relapse‐free (RFS), and overall survival (OS).
Results
Pretransplant forty‐six patients (72%) showed hematologic remission, including 21 (46%) MRD‐negative and 25 (54%) MRD‐positive patients indicated by WT1 expression, while 18 refractory patients (28%) showed active disease. Two‐year estimates of post‐transplant CIR, RFS, and OS were similar in MRD‐positive (61%, 37%, 54%) and refractory patients (70%, 26%, 56%), but significantly inferior compared with MRD‐negative patients (10%, 89%, 90%). After multivariable adjustment, pretransplant MRD negativity measured by WT1 expression retained its prognostic impact on CIR (P = .008), RFS (P = .005), and OS (P = .049).
Conclusions
PB WT1 expression represents a useful method to estimate pretransplant MRD, which is highly predictable for post‐transplant outcome and may help improving peri‐transplant management in AML/MDS patients.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33987857</pmid><doi>10.1111/ejh.13664</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-0611-1372</orcidid><orcidid>https://orcid.org/0000-0002-6662-7127</orcidid><orcidid>https://orcid.org/0000-0003-3255-721X</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | acute myeloid leukemia Adult Aged Biomarkers, Tumor Blood Cells Cell-Free Nucleic Acids Chemotherapy Female Gene Expression Hematopoietic Stem Cell Transplantation Humans Leukemia, Myeloid, Acute - genetics Leukemia, Myeloid, Acute - mortality Leukemia, Myeloid, Acute - pathology Leukemia, Myeloid, Acute - therapy Male measurable residual disease Middle Aged myelodysplastic syndrome Myelodysplastic Syndromes - genetics Myelodysplastic Syndromes - mortality Myelodysplastic Syndromes - pathology Myelodysplastic Syndromes - therapy Neoplasm, Residual - diagnosis Neoplasm, Residual - genetics Peripheral blood Preoperative Period Prognosis Recurrence relapse Remission Remission (Medicine) Retrospective Studies RNA, Messenger transplantation Transplantation, Homologous Treatment Outcome WT1 WT1 Proteins - genetics Young Adult |
title | Prognostic impact of pretransplant measurable residual disease assessed by peripheral blood WT1‐mRNA expression in patients with AML and MDS |
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