Significance of WT1 and multiparameter flow cytometry assessment in patients with chronic myelomonocytic leukemia receiving allogeneic hematopoietic stem cell transplantation.

Abstract

INTRODUCTION:

The objective of this study was to investigate the clinical significance of minimal residual disease (MRD) monitoring through Wilms tumor 1 (WT1) gene expression and multicolor flow cytometry (FCM) in patients with chronic myelomonocytic leukemia (CMML) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODS:

For this purpose, WT1 gene expression and the CMML-related abnormal immunophenotype were examined using real-time quantitative polymerase chain reaction and FCM, respectively.

RESULTS:

In total, 59 patients with CMML who underwent allo-HSCT were enrolled in this study. Thirteen cases (22.0%) developed hematological relapse, and 15 patients (25.4%) expired during the follow-up period. Thirty-four patients (37.6%) were positive for WT1 (WT1+), and 44 patients (74.6%) were positive for FCM prior to allo-HSCT. After allo-HSCT, there were 21 WT1+ patients (35.6%) and 10 patients (16.9%) who were positive in FCM (FCM+). Post-transplant WT1+ (post-WT1 0.6+; 50.7% vs. 7.6%, p < .001) and post-transplant FCM+ (post-FCM+; 90.0% vs. 8.8%, p < .001) indicated a higher 3-year cumulative incidence of relapse (CIR) compared with the WT1- or FCM-patients. Multivariate analysis of event-free survival (EFS), overall survival (OS), and CIR showed that the FCM status after transplantation was an independent prognostic factor for relapse (p < .05).

CONCLUSION:

Both FCM and WT1 after HSCT were identified as important predictors of recurrence of CMML following transplantation and may be useful in guiding interventions against disease relapse.

• Authors: Xinan Pan, Mengge Gao, Yuqian Sun, Yang Zhou, Ke Wang, Yu Wang, Lanping Xu, Xiaohui Zhang, Xiaojun Huang, Xiao-Su Zhao
• Journal: International journal of laboratory hematology (Int J Lab Hematol) Vol. 44 Issue 3 Pg. 510-517 (Jun 2022) ISSN: 1751-553X [Electronic] England
• PMID: 35061336 (Publication Type: Journal Article)
• Copyright: © 2022 John Wiley & Sons Ltd.

Chemical References

• WT1 Proteins
• WT1 protein, human

Topics

• Flow Cytometry
• Hematopoietic Stem Cell Transplantation
• Humans
• Leukemia, Myeloid, Acute (pathology)
• Leukemia, Myelomonocytic, Chronic (diagnosis, genetics, therapy)
• Leukemia, Myelomonocytic, Juvenile
• Neoplasm, Residual (diagnosis)
• Prognosis
• Recurrence
• Transplantation, Homologous
• WT1 Proteins (genetics)