BMSEHA15
Published online 27 January 2010
(Haematologica 2010, 10.3324/haematol.2009.011908)
Copyright © 2010 by Ferrata Storti Foundation
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Article

Early reduction of WT1 transcripts during induction chemotherapy predicts for longer disease-free and overall survival in acute myeloid leukemia

Giacomo Gianfaldoni*, Francesco Mannelli*, Vanessa Ponziani, Giovanni Longo, Sara Bencini, Alberto Bosi, Alessandro M. Vannucchi

UF di Ematologia, Dipartimento di Area Critica Medico-Chirurgica, Università degli Studi, Firenze, and Istituto Toscano Tumori

Correspondence: Professor Alessandro M. Vannucchi, UF of Hematology, Dipartimento di Area Critica, University of Florence, and Istituto Toscano Tumori, 50134 Florence, Italy. E-mail: amvannucchi{at}unifi.it Phone/ fax: international +39.055.7947.688. http://www.ematologiafirenze.com

ABSTRACT

We investigated the prognostic significance of early peripheral blast clearance as assessed by WT1 transcript reduction during the first days of standard induction therapy in 57 adult patients with acute myeloid leukemia (AML). Quantification of WT1 transcript by realtime quantitative PCR in peripheral blood on day 1 and 5 of treatment was performed. WT1 ratio was defined as the ratio of copy number measured on day 1 and on day 5. The median WT1 ratio was greater in patients attaining CR as compared to non responders (11.68 vs 2.14, respectively; p=0.0006). Furthermore, DFS and OS were significantly longer in patients displaying a WT1 ratio > 5.82 (i.e. the median value of whole cohort) than in patients with WT1 ratio 5.82 (p=0.024, and p<0.001, respectively). These data suggest that early decrease of WT1 copy number in peripheral blood predicts for better outcome and deserves potential implications for the management of AML patients.

Key words: acute myeloid Leukemia, WT1, peripheral blast clearance, prognosis.