Clinical significance of WT1 in the evaluation of therapeutic effect and prognosis of non-M3 acute myeloid leukemia

作者全名："Yu, Tingyu; Zhan, Qian; Yan, Xinyu; Luo, Xiaohua; Wang, Xin; Tang, Xiaoqiong; Zhang, Hongbin; Yang, Zesong; Chen, Jianbin; Liu, Lin; Wang, Li"

作者地址："[Yu, Tingyu; Yan, Xinyu; Luo, Xiaohua; Wang, Xin; Tang, Xiaoqiong; Zhang, Hongbin; Yang, Zesong; Chen, Jianbin; Liu, Lin; Wang, Li] Chongqing Med Univ, Dept Hematol, Affiliated Hosp 1, 1 Youyi Rd, Chongqing 400016, Peoples R China; [Zhan, Qian] Chongqing Med Univ, Mol Testing Ctr, Affiliated Hosp 1, Chongqing, Peoples R China"

通信作者："Wang, L (通讯作者)，Chongqing Med Univ, Dept Hematol, Affiliated Hosp 1, 1 Youyi Rd, Chongqing 400016, Peoples R China."

来源：CANCER BIOLOGY & THERAPY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001124175500001

JCR分区：Q2

影响因子：4.4

年份：2023

卷号：24

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Acute Myeloid leukemia; WT1; Minimal residual disease

摘要："To explore the clinical significance and prognosis of acute myeloid leukemia (AML) patients with WT1 mutations.In total, the clinical data of 269 adult patients with non-M3 AML were considered retrospectively. From these patients, 153 carried WT1 mutation whereas 116 were negative. WT1 mutation positive patients were further divided into WT1 low expression and high expression groups base on the expression level of WT1 by qPCR at diagnosis (cut off: 170500). Survival and therapeutic effect analysis were performed for the above patients with different interfering factors such as co-mutations, the extent of WT1 log reduction and the chemotherapy regimens. Patients with high WT1 expression have higher rate of relapse. We can accurately identify patients with inferior outcomes when we take the following factors into consideration: the WT1 expression level at diagnosis; different prognostic factors including co-mutations (especially NPM1 and FLT3-ITD); the log reduction of WT1 after induction therapy and the risk of stratification. Idarubicin + Cytarabine (IA) regimen could reduce the expression level of WT1 after treatment, and Allo-HSCT played an important role in improving the prognosis of patients with WT1 high expression and patients with WT1 negativity. Among the relapsed patients, there existed a rising trend of WT1-MRD in advance than MFC-MRD and that of patients with continuous complete remission (CR). Different clinical background should be taken into consideration when we judge the prognosis and therapeutic effect of patients with WT1 mutations. In addition, WT1 may be an optional MRD marker, which needs regular monitoring."

基金机构：Natural Science Foundation Project of CQ CSTC [cstc2018jcyjAX0688]

基金资助正文："This work was supported by Natural Science Foundation Project of CQ CSTC, [grant number: cstc2018jcyjAX0688]."