Bone marrow WT1 levels at diagnosis, post-induction and post-intensification in adult de novo AML

J. F. Nomdedéu, M. Hoyos, M. Carricondo, E. Bussaglia, C. Estivill, J. Esteve, M. Tormo, R. Duarte, O. Salamero, M. P.Q. De Llano, A. García, J. Bargay, I. Heras, J. M. Martí-Tutusaus, A. Llorente, J. M. Ribera, D. Gallardo, A. Aventin, S. Brunet, J. Sierra

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Abstract

We retrospectively assessed whether normalized bone marrow WT1 levels could be used for risk stratification in a consecutive series of 584 acute myeloid leukemia (AML) patients. A cutoff value of 5065 copies at diagnosis identified two prognostic groups (overall survival (OS): 44±3 vs 36±3%, P=0.023; leukemia-free survival (LFS): 47±3 vs 36±4%, P=0.038; and cumulative incidence of relapse (CIR): 37±3 vs 47±4%, P=:0.043). Three groups were identified on the basis of WT1 levels post-induction: Group 0 (WT1 between 0 and 17.5 copies, 134 patients, OS: 59±4%, LFS:59±4% and CIR: 26±4%); Group 1 (WT1 between 17.6 and 170.5 copies, 160 patients, OS: 48±5%, LFS:41±4% and CIR: 45±4%); and Group 2 (WT1 >170.5 copies, 71 patients, OS: 23±6%, LFS: 19±7% and CIR: 68±8%) (P<0.001). Post-intensification samples distinguished three groups: patients with WT1 >100 copies (47 patients, 16%); an intermediate group of patients with WT1 between 10 and 100 copies (148 patients, 52%); and a third group with WT1 <10 copies (92 patients, 32%). Outcomes differed significantly in terms of OS (30±7%, 59±4%, 72±5%), LFS (24±7%, 46±4%, 65±5%) and relapse probability (CIR 72±7%, 45±4%, 25±5%), all P<0.001. WT1 levels in bone marrow assayed using the standardized ELN method provide relevant prognostic information in de novo AML. © 2013 Macmillan Publishers Limited.
Original languageEnglish
Pages (from-to)2157-2164
JournalLeukemia
Volume27
Issue number11
DOIs
Publication statusPublished - 1 Jan 2013

Keywords

  • minimal residual disease
  • molecular diagnostics
  • WT1

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