Shibasaki Yasuhiko, Seki Yoshinobu, Tanaka Tomoyuki, Miyakoshi Syukuko, Fuse Kyoko, Kozakai Takashi, Kobayashi Hironori, Ushiki Takashi, Abe Takashi, Yano Toshio, Moriyama Masato, Kuroha Takashi, Isahai Noriatsu, Takizawa Jun, Narita Miwako, Koyama Satoru, Furukawa Tatsuo, Sone Hirohito, Masuko Masayoshi
Department of Stem Cell Transplantation, Niigata University Medical and Dental Hospital, Niigata, Japan.
Niigata Prefectural Shibata Hospital, Shibata, Niigata, Japan.
Leuk Res. 2015 Jun;39(6):667-71. doi: 10.1016/j.leukres.2015.03.021. Epub 2015 Apr 7.
We focused on the level of reduction of Wilms' tumor gene 1 (WT1) mRNA in bone marrow as minimal residual disease during chemotherapies in adult acute myeloid leukemia (AML) patients. Forty-eight patients were enrolled in this study. Log levels of reduction of WT1 mRNA transcript after induction therapy compared with those at diagnosis were associated with disease-free survival (DFS) (P=0.0066) and overall survival (OS) (P=0.0074) in patients who achieved complete remission. Also log levels of reduction of WT1 mRNA transcript after final consolidation therapy compared with those at diagnosis were associated with DFS (P=0.015) and OS (P=0.012). By multivariate analysis, log levels of reduction of WT1 mRNA transcript after induction therapy and after final consolidation therapy compared with those at diagnosis were extracted as risk factors for outcome. Our results suggest that early and deep reduction of tumor burden may be important for the outcome of AML patients. In addition, it may be useful for the decision to proceed with allogeneic SCT as post-remission therapy.
我们聚焦于成人急性髓系白血病（AML）患者化疗期间作为微小残留病的骨髓中威尔姆斯瘤基因1（WT1）mRNA的降低水平。本研究纳入了48例患者。诱导治疗后WT1 mRNA转录本降低的对数水平与诊断时相比，与达到完全缓解患者的无病生存期（DFS）（P = 0.0066）和总生存期（OS）（P = 0.0074）相关。最终巩固治疗后WT1 mRNA转录本降低的对数水平与诊断时相比，也与DFS（P = 0.015）和OS（P = 0.012）相关。通过多变量分析，诱导治疗后和最终巩固治疗后WT1 mRNA转录本降低的对数水平与诊断时相比被提取为预后的危险因素。我们的结果表明，早期且深度降低肿瘤负荷可能对AML患者的预后很重要。此外，这对于决定是否进行异基因造血干细胞移植作为缓解后治疗可能是有用的。
