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
Hauptverfasser: Rautenberg, Christina, Lauseker, Michael, Kaivers, Jennifer, Jäger, Paul, Fischermanns, Carolin, Pechtel, Sabrina, Haas, Rainer, Kobbe, Guido, Germing, Ulrich, Schroeder, Thomas
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container_end_page 292
container_issue 2
container_start_page 283
container_title European journal of haematology
container_volume 107
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.
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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 &amp; Sons Ltd.</rights><rights>2021 The Authors. European Journal of Haematology published by John Wiley &amp; 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). 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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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