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Prognostic impact of peripheral blood WT1 mRNA dynamics in patients with acute myeloid leukemia treated with venetoclax combination therapy.
Sato, Honami; Kobayashi, Takahiro; Kameoka, Yoshihiro; Teshima, Kazuaki; Watanabe, Atsushi; Yamada, Masahiro; Yamashita, Takaya; Noguchi, Shinsuke; Michisita, Yoshihiro; Fujishima, Naohito; Kuroki, Jun; Takahashi, Naoto.
Afiliación
  • Sato H; Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
  • Kobayashi T; Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. takahiro@med.akita-u.ac.jp.
  • Kameoka Y; Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
  • Teshima K; Department of Hematology, Hiraka General Hospital, Yokote, Japan.
  • Watanabe A; Department of Hematology, Nephrology and Rheumatology, Omagari Kousei Medical Center, Daisen, Japan.
  • Yamada M; Department of Hematology, Akita City Hospital, Akita, Japan.
  • Yamashita T; Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
  • Noguchi S; Department of Hematology, Hiraka General Hospital, Yokote, Japan.
  • Michisita Y; Department of Hematology, Nephrology and Rheumatology, Omagari Kousei Medical Center, Daisen, Japan.
  • Fujishima N; Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
  • Kuroki J; Department of Hematology, Akita Red Cross Hospital, Akita, Japan.
  • Takahashi N; Department of Hematology, Akita Kousei Medical Center, Akita, Japan.
Int J Clin Oncol ; 29(4): 481-492, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38334897
ABSTRACT

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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sulfonamidas / Leucemia Mieloide Aguda / Tumor de Wilms / Compuestos Bicíclicos Heterocíclicos con Puentes / Neoplasias Renales Tipo de estudio: Prognostic_studies Límite: Adult / Aged / Aged80 / Humans / Middle aged Idioma: En Revista: Int J Clin Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sulfonamidas / Leucemia Mieloide Aguda / Tumor de Wilms / Compuestos Bicíclicos Heterocíclicos con Puentes / Neoplasias Renales Tipo de estudio: Prognostic_studies Límite: Adult / Aged / Aged80 / Humans / Middle aged Idioma: En Revista: Int J Clin Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón