TY - JOUR
T1 - Wilms Tumor 1 Expression and Pre-emptive Immunotherapy in Patients with Acute Myeloid Leukemia Undergoing an Allogeneic Hemopoietic Stem Cell Transplantation
AU - Di Grazia, Carmen
AU - Pozzi, Sarah
AU - Geroldi, Simona
AU - Grasso, Raffaella
AU - Miglino, Maurizio
AU - Colombo, Nicoletta
AU - Tedone, Elisabetta
AU - Luchetti, Silvia
AU - Lamparelli, Teresa
AU - Gualandi, Francesca
AU - Ibatici, Adalberto Cristiano
AU - Bregante, Stefania
AU - Van Lint, Maria Teresa
AU - Raiola, Anna Maria
AU - Dominietto, Alida
AU - Varaldo, Riccardo
AU - Galaverna, Federica
AU - Ghiso, Anna
AU - Sica, Simona
AU - Bacigalupo, Andrea
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Minimal residual disease (MRD) was monitored by Wilms tumor 1 (WT1) expression in 207 patients with acute myeloid leukemia (AML) after an allogeneic hemopoietic stem cell transplantation (HSCT) as a trigger to initiate pre-emptive immunotherapy (IT) with cyclosporin discontinuation and/or donor lymphocyte infusion. The trigger for IT was WT1 ≥ 180 copies/104 Abelson cells in marrow cells in the first group of 122 patients (WT1-180) and ≥ 100 copies in a subsequent group of 85 patients (WT1-100). Forty patients received IT. The cumulative incidence (CI) of relapse was 76% in WT1-180 (n = 17) versus 29% in WT1-100 patients (n = 23) receiving IT (P = .006); the leukemia-free survival from MRD positivity was 23% versus 74%, respectively (P = .003). We then looked at the entire AML patient population (n = 207). WT1-180 and WT1-100 patients were comparable for disease phase and age. The overall 4-year CI of transplantation-related mortality was 13% in both groups; the CI of leukemia relapse was 38% in the WT1-180 and 28% in the WT1-100 patients (P = .05) and leukemia-free survival was 56% versus 48%, respectively (P = .07). In conclusion, we suggests that WT1-based pre-emptive immunotherapy is feasible in patients with undergoing an allogeneic HSCT. The protective effect on relapse is greater when IT is triggered at lower levels of WT1.
AB - Minimal residual disease (MRD) was monitored by Wilms tumor 1 (WT1) expression in 207 patients with acute myeloid leukemia (AML) after an allogeneic hemopoietic stem cell transplantation (HSCT) as a trigger to initiate pre-emptive immunotherapy (IT) with cyclosporin discontinuation and/or donor lymphocyte infusion. The trigger for IT was WT1 ≥ 180 copies/104 Abelson cells in marrow cells in the first group of 122 patients (WT1-180) and ≥ 100 copies in a subsequent group of 85 patients (WT1-100). Forty patients received IT. The cumulative incidence (CI) of relapse was 76% in WT1-180 (n = 17) versus 29% in WT1-100 patients (n = 23) receiving IT (P = .006); the leukemia-free survival from MRD positivity was 23% versus 74%, respectively (P = .003). We then looked at the entire AML patient population (n = 207). WT1-180 and WT1-100 patients were comparable for disease phase and age. The overall 4-year CI of transplantation-related mortality was 13% in both groups; the CI of leukemia relapse was 38% in the WT1-180 and 28% in the WT1-100 patients (P = .05) and leukemia-free survival was 56% versus 48%, respectively (P = .07). In conclusion, we suggests that WT1-based pre-emptive immunotherapy is feasible in patients with undergoing an allogeneic HSCT. The protective effect on relapse is greater when IT is triggered at lower levels of WT1.
KW - Acute myeloid leukemia
KW - Allogeneic hemopoietic stem cell transplantation
KW - Wilms tumor 1 (WT1)
UR - http://www.scopus.com/inward/record.url?scp=84975252118&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84975252118&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2016.03.005
DO - 10.1016/j.bbmt.2016.03.005
M3 - Article
AN - SCOPUS:84975252118
VL - 22
SP - 1242
EP - 1246
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
IS - 7
ER -