title: WT1 vaccination in acute myeloid leukemia: new methods of implementing adoptive immunotherapy.
abstract: BACKGROUND
  The Wilms tumor 1 (WT1) gene was originally identified as a tumor suppressor gene that, when mutated, would lead to the development of pediatric renal tumors. More recently, it has been determined that WT1 is overexpressed in 90% of patients with acute myeloid leukemia (AML) and is mutated in approximately 10% of AML patients. WT1 plays a role in normal hematopoiesis and, in AML specifically, it has oncogenic function and plays an important role in cellular proliferation and differentiation. The ubiquity of WT1 in leukemia has lead to the development of vaccines aimed at employing the host immune system to mount a T-cell response to a known antigen.
  
  
  METHODS
  In this evaluation, the authors discuss the role of WT1 in normal hematopoiesis as well as in the development of hematologic malignancies. Furthermore, the authors discuss the data supporting the development of WT1 vaccines, and the clinical trials supporting their use in patients with acute leukemia.
  
  
  CONCLUSIONS
  Several small trials have been conducted which support the safety and efficacy of this therapy, although larger trials are certainly warranted. In the authors' opinion, the WT1 vaccination has potential in terms of its application as an adjuvant therapy for patients with AML who are at high risk of relapse or who have detectable minimal residual disease after initial standard therapy.
authors: Duke University Medical Center, Division of Hematologic Malignancies and Cellular Therapy , DUMC Box 3841, Durham, NC 27710 , USA +1 919 684 2287 ; +1 919 664 3309 ; lindsay.rein@duke.edu.
authors: Lindsay A M
authors: LA
authors: Rein
authors: Nelson J
authors: NJ
authors: Chao
mesh_terms: D000818:Animals; D019496:Cancer Vaccines / Q000627:therapeutic use*; D016162:Genes, Wilms Tumor; D006801:Humans; D016219:Immunotherapy, Adoptive; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000276:immunology / Q000628:therapy*; D022223:Vaccines, Subunit / Q000627:therapeutic use; D025721:WT1 Proteins / Q000235:genetics* / Q000276:immunology
chemical_list: D019496:Cancer Vaccines; D022223:Vaccines, Subunit; D025721:WT1 Proteins