Prognostic impact of peripheral blood WT1 mRNA dynamics in patients with acute myeloid leukemia treated with venetoclax combination therapy

被引：0

作者：

Sato, Honami ^{[1
]}

Kobayashi, Takahiro ^{[1
]}

Kameoka, Yoshihiro ^{[1
]}

Teshima, Kazuaki ^{[2
]}

Watanabe, Atsushi ^{[3
,4
]}

Yamada, Masahiro ^{[1
,2
,3
]}

Yamashita, Takaya ^{[1
]}

Noguchi, Shinsuke ^{[5
]}

Michisita, Yoshihiro ^{[6
]}

Fujishima, Naohito ^{[7
]}

Kuroki, Jun ^{[8
]}

Takahashi, Naoto ^{[1
]}

机构：

[1] Akita Univ, Dept Hematol Nephrol & Rheumatol, Grad Sch Med, 1-1-1 Hondo, Akita 0108543, Japan

[2] Hiraka Gen Hosp, Dept Hematol, Yokote, Japan

[3] Omagari Kousei Med Ctr, Dept Hematol Nephrol & Rheumatol, Daisen, Japan

[4] Akita City Hosp, Dept Hematol, Akita, Japan

[5] Akita Red Cross Hosp, Dept Hematol, Akita, Japan

[6] Akita Kousei Med Ctr, Dept Hematol, Akita, Japan

[7] Noshiro Kosei Med Ctr, Dept Hematol Nephrol & Rheumatol, Noshiro, Japan

[8] Yuri Kumiai Gen Hosp, Dept Internal Med, Yurihonjo, Japan

来源：

INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY | 2024年 / 29卷 / 04期

关键词：

Acute myeloid leukemia; Venetoclax; Azacitidine; Measurable residual disease; WT1; mRNA; Predictive factor; MEASURABLE RESIDUAL DISEASE; STEM-CELL TRANSPLANTATION; USEFUL TOOL; EXPRESSION; DIAGNOSIS; RECOMMENDATIONS; PREDICTS; SURVIVAL; OUTCOMES; PCR;

D O I：

10.1007/s10147-024-02480-9

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background Wilms' tumor gene 1 (WT1) mRNA quantification is a useful marker of measurable residual disease in acute myeloid leukemia (AML). However, whether monitoring the WT1 mRNA levels may predict the outcome of venetoclax (VEN) combination therapy in AML is not reported. This study aims to elucidate whether WT1 mRNA dynamics could predict long-term prognosis. Methods 33 patients with untreated or relapsed/refractory AML evaluated for peripheral blood WT1 dynamics in VEN combination therapy were analyzed. Results The median age was 73 years (range 39-87). Azacitidine was combined with VEN in 91% of patients. Overall, the median overall survival (OS) was 334 days (95% CI 210-482), and the complete remission (CR) plus CR with incomplete hematologic recovery rate was 59%. A 1-log reduction of WT1 mRNA values by the end of cycle 2 of treatment was associated with significantly better OS and event-free survival (EFS) (median OS 482 days vs. 237 days, p = 0.049; median EFS 270 days vs. 125 days, p = 0.02). The negativity of post-treatment WT1 mRNA value during the treatment was associated with significantly better OS and EFS (median OS 482 days vs. 256 days, p = 0.02; median EFS not reached vs. 150 days, p = 0.005). Multivariate analysis confirmed the significance of these two parameters as strong EFS predictors (HR 0.26, p = 0.024 and HR 0.15, p = 0.013, respectively). The increase in WT1 mRNA values was correlated with relapse. Conclusion This study demonstrates that WT1 mRNA dynamics can be a useful marker for assessing long-term prognosis of VEN combination therapy for AML.

引用

页码：481 / 492

页数：12

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