title: Peripheral blood WT1 expression predicts relapse in AML patients undergoing allogeneic stem cell transplantation.
abstract: To evaluate if WT1 expression may predict relapse after allo-SCT, we analyzed WT1 levels on peripheral blood (PB) and bone marrow (BM) before and after allo-SCT in 24 AML patients with WT1 overexpression at diagnosis. Five copies of WT1/ABL × 10(4) from PB were identified as the threshold value that correlated with relapse after allo-SCT. The same correlation was not identified when WT1 expression was assessed from bone marrow (BM). Eight out of 11 (73%) patients with a pre-allo-SCT PB-WT1 ≥ 5 and 4/13 (31%) patients with a pre-allo-SCT PB-WT1 < 5 relapsed, respectively (P = 0.04). The incidence of relapse was higher in patients with PB-WT1 ≥ 5 measured after allo-SCT, at the 3rd (56% versus 38%; P = 0.43) and at the 6th month (71% versus 20%; P = 0.03). Patients with pretransplant PB-WT1 < 5 had significantly better 2-year OS and LFS than patients with a PB-WT1 ≥ 5 (81% versus 0% and 63% versus 20%) (P = 0.02). Our data suggest the usefulness of WT1 monitoring from PB to predict the relapse in allotransplanted AML patients and to modulate the intensity of conditioning and/or the posttransplant immunosuppression in an attempt to reduce the posttransplant relapse risk.
authors.affiliation: Unit of Blood Disease and Stem Cell Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Malagola
authors.affiliation: Unit of Blood Disease and Stem Cell Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Skert
authors.affiliation: Chair of Biochemistry, Department of Molecular and Translational Medicine, Univeristy of Brescia, Laboratorio Analisi, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Ruggeri
authors.affiliation: Unit of Blood Disease and Stem Cell Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Alessandro
authors.identifier: 0000-0003-4257-3862
authors.initials: A
authors.lastname: Turra
authors.affiliation: Unit of Blood Disease and Stem Cell Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Ribolla
authors.affiliation: Unit of Blood Disease and Stem Cell Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Valeria
authors.identifier: 0000-0002-0063-9002
authors.initials: V
authors.lastname: Cancelli
authors.affiliation: Unit of Blood Disease and Stem Cell Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Federica
authors.identifier: 0000-0002-9988-2634
authors.initials: F
authors.lastname: Cattina
authors.affiliation: Unit of Blood Disease and Stem Cell Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Elisa
authors.identifier: 0000-0003-4245-3908
authors.initials: E
authors.lastname: Alghisi
authors.affiliation: Unit of Blood Disease and Stem Cell Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Bernardi
authors.affiliation: Unit of Blood Disease and Stem Cell Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Simone
authors.identifier: 0000-0003-1195-7708
authors.initials: S
authors.lastname: Perucca
authors.affiliation: Unit of Blood Disease and Stem Cell Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Andrea
authors.identifier: 0000-0001-5937-4806
authors.initials: A
authors.lastname: Di Palma
authors.affiliation: Division of Hematology, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Erika
authors.initials: E
authors.lastname: Borlenghi
authors.affiliation: Unit of Blood Disease and Stem Cell Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Pagani
authors.affiliation: Division of Hematology, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rossi
authors.affiliation: Chair of Biochemistry, Department of Molecular and Translational Medicine, Univeristy of Brescia, Laboratorio Analisi, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Caimi
authors.affiliation: Unit of Blood Disease and Stem Cell Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, AO Spedali Civili di Brescia, P.le Ospedali Civili 1, 25123 Brescia, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Russo
mesh_terms: D000328:Adult; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood* / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D011379:Prognosis; D033581:Stem Cell Transplantation; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D025721:WT1 Proteins / Q000097:blood*
chemical_list: D025721:WT1 Proteins; C583751:WT1 protein, human