title: Integrating post induction WT1 quantification and flow-cytometry results improves minimal residual disease stratification in acute myeloid leukemia.
abstract: Fifty uniformly treated adult AML patients were analyzed with respect to pre-treatment and post-induction risk factors. Forty-two patients achieving complete hematological remission were assessed for minimal residual disease (MRD) by WT1 gene expression; 34 by flow-cytometry (flow-MRD). Patients who were flow-MRD negative had a better 3-year disease-free (DFS; 79.5% vs. 27.3%; p=.032) compared with patients who were still positive after induction. Interestingly, DFS of flow-MRD positive patients was not related to the amount of flow-detected clone population (≥ or <1%, p=.41) but to WT1 reduction (ΔWT1, 3-year DFS; 46.2% vs. 0% if ΔWT1 was ≥ or < of 1.5 log, p=.001). In AML, combining MRD results provided by WT1 quantification and flow-cytometry improves the reliability of MRD-based prognostic stratification. Similar analyses by further larger studies should be advocated.
authors.affiliation: Department of Hematology and Oncology, IRCCS AOU S.Martino-IST, Genova, Italy. Electronic address: S3320154@unige.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Marani
authors.forename: Marino
authors.initials: M
authors.lastname: Clavio
authors.forename: Raffaella
authors.initials: R
authors.lastname: Grasso
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Colombo
authors.forename: Fabio
authors.initials: F
authors.lastname: Guolo
authors.forename: Annalisa
authors.initials: A
authors.lastname: Kunkl
authors.forename: Filippo
authors.initials: F
authors.lastname: Ballerini
authors.forename: Livia
authors.initials: L
authors.lastname: Giannoni
authors.forename: Chiara
authors.initials: C
authors.lastname: Ghiggi
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Fugazza
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Ravetti
authors.forename: Marco
authors.initials: M
authors.lastname: Gobbi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Miglino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000235:genetics; D001853:Bone Marrow / Q000473:pathology; D020732:Cytogenetic Analysis; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D060828:Induction Chemotherapy; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D016896:Treatment Outcome; D025721:WT1 Proteins / Q000235:genetics*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D025721:WT1 Proteins; C583751:WT1 protein, human
keywords: Acute myeloid leukemia; Early response assessment; Flow-cytometry; Minimal residual disease; Prognosis; Wilms’ tumor gene