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Wu J, Yan H, Xiang C. Wilms' tumor gene 1 in hematological malignancies: friend or foe? Hematology 2023; 28:2254557. [PMID: 37668240 DOI: 10.1080/16078454.2023.2254557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/29/2023] [Indexed: 09/06/2023] Open
Abstract
Wilms' tumor gene 1 (WT1) is a transcription and post-translational factor that has a crucial role in the biological and pathological processes of several human malignancies. For hematological malignancies, WT1 overexpression or mutation has been found in leukemia and myelodysplastic syndrome. About 70-90% of acute myeloid leukemia patients showed WT1 overexpression, and 6-15% of patients carried WT1 mutations. WT1 has been widely regarded as a marker for monitoring minimal residual disease in acute myeloid leukemia. Many researchers were interested in developing WT1 targeting therapy. In this review, we summarized biological and pathological functions, correlation with other genes and clinical features, prognosis value and targeting therapy of WT1 in hematological features.
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Affiliation(s)
- Jie Wu
- Department of Emergency Medicine, The Fifth People's Hospital of Huai'an and Huai'an Hospital Affiliated to Yangzhou University, Huai'an, People's Republic of China
| | - Hui Yan
- Department of Clinical Medicine, Medical College, Yangzhou University, Yangzhou, People's Republic of China
| | - Chunli Xiang
- Department of General Medicine, The Affiliated Huai'an Hospital of Xuzhou Medical University and Huai'an Second People's Hospital, Huai'an, People's Republic of China
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Ishiyama K, Dung TC, Imi T, Hosokawa K, Nannya Y, Yamazaki H, Ogawa S, Nakao S. Clinical significance of the increased expression of the WT1 gene in peripheral blood of patients with acquired aplastic anemia. EJHAEM 2022; 3:1116-1125. [PMID: 36467821 PMCID: PMC9713059 DOI: 10.1002/jha2.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 08/23/2022] [Indexed: 06/17/2023]
Abstract
To determine the significance of increased Wilms tumor 1 (WT1) gene expression in the peripheral blood of patients with acquired aplastic anemia (AA), we analyzed serial changes in WT1 mRNA copy number (WT1cn) in 63 patients with AA as well as in five patients with myelodysplastic syndromes (MDS) and seven patients with paroxysmal nocturnal hemoglobinuria (PNH). WT1cn was higher than the cut-off (≥50 copies/μg RNA) at the time of the first measurement in 41% of untreated (60-190 copies/μg RNA [median 130]) and 59% of treated (59-520 copies/μg RNA [median 150]) AA patients. Although WT1cns gradually increased in most AA patients during the 2-105 months follow-up period, they did not lead to clonal evolution except in three patients in whom the maximum change ratio of WT1cn (WT1cn-change max), defined as the ratio of WT1cn at the first examination to that of the maximum value, exceeded 20.0 and who developed MDS at 2, 46, and 105 months. Increased WT1 gene expression was enriched in granulocytes rather than in mononuclear cells in most WT1-positive AA patients and did not correlate with mutations of genes associated with myeloid malignancy. WT1cns were high at 690-5700 (median 2000) in MDS patients and remained high thereafter, while WT1cns in PNH patients (77-200; median 96) were similar to those in AA. Thus, moderate increases in WT1cns up to 600 are common in AA patients in stable remission. An increase in the WT1cn-change max over 20.0 may portend transformation from AA to MDS.
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Affiliation(s)
- Ken Ishiyama
- Department of HematologyKanazawa University HospitalKanazawaIshikawaJapan
| | - Tran Cao Dung
- Department of HematologyKanazawa University HospitalKanazawaIshikawaJapan
| | - Tatsuya Imi
- Department of HematologyKanazawa University HospitalKanazawaIshikawaJapan
| | - Kohei Hosokawa
- Department of HematologyKanazawa University HospitalKanazawaIshikawaJapan
| | - Yasuhito Nannya
- Department of Pathology and Tumor BiologyGraduate School of MedicineKyoto UniversityKyotoJapan
- Division of Hematopoietic Disease ControlInstitute of Medical ScienceThe University of TokyoTokyoJapan
| | - Hirohito Yamazaki
- Department of HematologyKanazawa University HospitalKanazawaIshikawaJapan
| | - Seishi Ogawa
- Department of Pathology and Tumor BiologyGraduate School of MedicineKyoto UniversityKyotoJapan
- Institute for the Advanced Study of Human BiologyKyoto UniversityKyotoJapan
- Center for Hematology and Regenerative MedicineKarolinska InstituteStockholmSweden
| | - Shinji Nakao
- Department of HematologyKanazawa University HospitalKanazawaIshikawaJapan
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Targeting intracellular WT1 in AML with a novel RMF-peptide-MHC specific T-cell bispecific antibody. Blood 2021; 138:2655-2669. [PMID: 34280257 DOI: 10.1182/blood.2020010477] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 07/01/2021] [Indexed: 11/20/2022] Open
Abstract
Antibody-based immunotherapy is a promising strategy for targeting chemo-resistant leukemic cells. However, classical antibody-based approaches are restricted to targeting lineage-specific cell-surface antigens. By targeting intracellular antigens, a large number of other leukemia-associated targets would become accessible. In this study, we evaluated a novel T-cell bispecific (TCB) antibody, generated using CrossMab and knob-into-holes technology, containing a bivalent T-cell receptor-like binding domain that recognizes the RMFPNAPYL peptide derived from the intracellular tumor antigen Wilms' tumor 1 (WT1) in the context of human leukocyte antigen (HLA) A*02. Binding to CD3ε recruits T cells irrespective of their T-cell receptor specificity. WT1-TCB elicited antibody-mediated T-cell cytotoxicity against AML cell lines in a WT1- and HLA-restricted manner. Specific lysis of primary AML cells was mediated in ex vivo long-term co-cultures utilizing allogenic (mean specific lysis: 67±6% after 13-14 days; ±SEM; n=18) or autologous, patient-derived T cells (mean specific lysis: 54±12% after 11-14 days; ±SEM; n=8). WT1-TCB-treated T cells exhibited higher cytotoxicity against primary AML cells than an HLA-A*02 RMF-specific T-cell clone. Combining WT1-TCB with the immunomodulatory drug lenalidomide further enhanced antibody-mediated T-cell cytotoxicity against primary AML cells (mean specific lysis on day 3-4: 45.4±9.0% vs 70.8±8.3%; p=0.015; ±SEM; n=9-10). In vivo, WT1-TCB-treated humanized mice bearing SKM-1 tumors showed a significant and dose-dependent reduction in tumor growth. In summary, we show that WT1-TCB facilitates potent in vitro, ex vivo and in vivo killing of AML cell lines and primary AML cells; these results led to the initiation of a phase I trial in patients with r/r AML (NCT04580121).
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Overexpression of WT1 and PRAME predicts poor outcomes of patients with myelodysplastic syndromes with thrombocytopenia. Blood Adv 2020; 3:3406-3418. [PMID: 31714962 DOI: 10.1182/bloodadvances.2019000564] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 09/11/2019] [Indexed: 12/16/2022] Open
Abstract
Thrombocytopenia is associated with life-threatening bleeding and is common in myelodysplastic syndromes (MDS). Robust molecular prognostic biomarkers need to be developed to improve clinical decision making for patients with MDS with thrombocytopenia. Wilms tumor 1 (WT1) and preferentially expressed antigen in melanoma (PRAME) are promising immunogenic antigen candidates for immunotherapy, and their clinical effects on patients with MDS with thrombocytopenia are still not well understood. We performed a multicenter observational study of adult patients with MDS with thrombocytopenia from 7 different tertiary medical centers in China. We examined bone marrow samples collected at diagnosis for WT1 and PRAME transcript levels and then analyzed their prognostic effect for patients with MDS with thrombocytopenia. In total, we enrolled 1110 patients diagnosed with MDS with thrombocytopenia. Overexpression of WT1 and PRAME was associated with elevated blast percentage, worse cytogenetics, and higher Revised International Prognostic Scoring System (IPSS-R) risk. Further, both WT1 and PRAME overexpression were independent poor prognostic factors for acute myeloid leukemia evolution, overall survival, and progression-free survival. Together, the 2 genes overexpression identified a population of patients with MDS with substantially worse survival. On the basis of WT1 and PRAME transcript levels, patients with MDS with IPSS-R low risk were classified into 2 significantly divergent prognostic risk groups: a low-favorable group and a low-adverse group. The low-adverse group had survival similar to that of patients in the intermediate-risk group. Our study demonstrates that the evaluation of WT1/PRAME transcript analysis may improve the prognostication precision and better risk-stratify the patients.
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Dewispelaere L, Bleret L, Van Acker T, Van Branteghem C, Cochaux P, Heimann P, El Housni H. One-Step Duplex Droplet Digital PCR for WT1 Overexpression. J Mol Diagn 2020; 22:1008-1019. [PMID: 32540368 DOI: 10.1016/j.jmoldx.2020.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 05/07/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022] Open
Abstract
With the improvement of treatment methods in acute hematology malignancies, the development of sensitive tools for minimal residual disease assessment has become a priority. The monitoring of WT1 expression level by real-time quantitative PCR has been a standard for minimal residual disease evaluation in acute myeloid leukemia and, since 2009, has been optimized through a European LeukemiaNet effort in an established protocol with well-defined clinical end points. Building on the work of the European LeukemiaNet, this article reports the development of a novel, one-step duplex WT1/ABL1 droplet digital assay for WT1 overexpression detection. This assay provides accurate data with high precision and linearity, even at low-template concentration, while retaining strong correlation with the standardized method and therefore maintaining the framework to analyze the results in the context of acute myeloid leukemia patients.
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Affiliation(s)
- Laurent Dewispelaere
- Department of Molecular Hemato-Oncology, Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), The Free University of Brussels, Brussels, Belgium.
| | - Leonore Bleret
- Department of Molecular Hemato-Oncology, Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), The Free University of Brussels, Brussels, Belgium
| | - Tom Van Acker
- Department of Molecular Hemato-Oncology, Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), The Free University of Brussels, Brussels, Belgium
| | - Cindy Van Branteghem
- Department of Molecular Hemato-Oncology, Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), The Free University of Brussels, Brussels, Belgium
| | - Pascale Cochaux
- Department of Molecular Hemato-Oncology, Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), The Free University of Brussels, Brussels, Belgium
| | - Pierre Heimann
- Department of Molecular Hemato-Oncology, Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), The Free University of Brussels, Brussels, Belgium
| | - Hakim El Housni
- Department of Molecular Hemato-Oncology, Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), The Free University of Brussels, Brussels, Belgium
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Wang XR, Chang Y, Yuan XY, Wang YZ, Qin YZ, Ruan GR, Lai YY, Liu YR. Overexpressed WT1 exhibits a specific immunophenotype in intermediate and poor cytogenetic risk acute myeloid leukemia. Ann Hematol 2020; 99:215-221. [PMID: 31900500 DOI: 10.1007/s00277-019-03808-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 09/26/2019] [Indexed: 11/30/2022]
Abstract
Many studies have confirmed that overexpressed WT1 exists in leukemic cells, especially in AML. However, the immunophenotypic features of this sort of leukemic cells remain to be unclarified. We retrospectively analyzed the immunophenotype of 283 newly diagnosed AML patients with intermediated and poor cytogenetic risk to evaluate the correlation between phenotype and WT1 overexpression. EVI1 transcripts, KMT2A-PTD, FLT3-ITD, and NPM1 mutations were simultaneously assessed. Our results revealed that overexpressed WT1 was significantly associated with the expression of CD117, CD13, and CD123. Besides, leukemic cells with WT1 overexpression also lacked lymphoid and myeloid differentiation-related markers. FAB subtype M2 patients had higher WT1 levels, compared with other FAB subtype. Multivariate analysis was proved that NPM1 mutation, M2 subtype, and the expression of CD123 were independently associated with WT1 overexpression. These indicated that AML with overexpressed WT1 was proliferated and blocked in the early stage of AML development. It presumably provided some clues to detect overexpressed WT1 cells via multiparameter flow cytometry. CD123-targeted drugs might become one of the alternative treatments for patients with WT1 overexpression.
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Affiliation(s)
- Xiao-Rui Wang
- Department of Clinical Laboratory, Shanghai General Hospital, Shanghai, China.,Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South St, Beijing, 100044, China
| | - Yan Chang
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South St, Beijing, 100044, China
| | - Xiao-Ying Yuan
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South St, Beijing, 100044, China
| | - Ya-Zhe Wang
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South St, Beijing, 100044, China
| | - Ya-Zhen Qin
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South St, Beijing, 100044, China
| | - Guo-Rui Ruan
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South St, Beijing, 100044, China
| | - Yue-Yun Lai
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South St, Beijing, 100044, China
| | - Yan-Rong Liu
- Department of Hematology, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South St, Beijing, 100044, China.
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Treatment of Molecular Relapse by Cessation of Immunosuppression After Hematopoietic Stem Cell Transplantation in Pediatric FLT3-ITD AML Monitored by WT1 Expression in Peripheral Blood. J Pediatr Hematol Oncol 2019; 41:417-419. [PMID: 31238330 DOI: 10.1097/mph.0000000000001365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Relapse after hematopoietic stem cell transplantation in pediatric acute myeloid leukemia is a fatal event in the majority of cases. Immunotherapy may prevent an impending relapse if instituted at first molecular evidence of disease recurrence. Wilms tumor gene 1 (WT1) is overexpressed in the majority of children and may constitute a useful molecular marker of measurable residual disease applicable for disease monitoring in peripheral blood where the background amplification from healthy hematopoiesis is less prevalent compared with bone marrow. We report the measurable residual disease kinetics from a child with FLT3-internal tandem duplication acute myeloid leukemia where sequential WT1 monitoring in peripheral blood-guided withdrawal of immunosuppression.
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Løvvik Juul-Dam K, Guldborg Nyvold C, Vålerhaugen H, Zeller B, Lausen B, Hasle H, Beier Ommen H. Measurable residual disease monitoring using Wilms tumor gene 1 expression in childhood acute myeloid leukemia based on child-specific reference values. Pediatr Blood Cancer 2019; 66:e27671. [PMID: 30900388 DOI: 10.1002/pbc.27671] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 01/16/2019] [Accepted: 01/30/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND Measurable/minimal residual disease (MRD) monitoring can predict imminent hematological relapse in acute myeloid leukemia (AML). The majority of childhood AML patients do not harbor fusion genes or mutations applicable as MRD markers and overexpression of Wilms tumor gene 1 (WT1) may constitute a useful monitoring target. However, age-specific reference values in healthy hematopoiesis and standardization of WT1 assessment are prerequisites for clinical utility. PROCEDURE We investigated WT1 expression across age in hematologically healthy controls (n = 109), during suspected infection (n = 90) and bone marrow (BM) regeneration (n = 13). WT1 expression in AML at diagnosis (n = 91) and during follow-up (n = 30) was compared with age-specific reference values. RESULTS WT1 expression correlated with age and showed higher levels in both BM and peripheral blood (PB) in children compared with adults (P < 0.001 and P = 0.01). WT1 expression from healthy hematopoiesis was lower in PB compared with BM (WT1BM /WT1PB = 8.6, 95% CI: 5.3-13.7) and not influenced by infection nor BM regeneration. At AML diagnosis, 66% had more than 20-fold WT1 overexpression in PB or BM (PB 74%; BM 45%). WT1 was quantified in 279 PB samples during follow-up. All 11 patients with PB sampling within 4 months of disease recurrence displayed WT1 overexpression by a median of 1.9 months (range, 0.7-9.7) before hematological relapse. CONCLUSIONS This study defines child-specific reference values for WT1 expression in healthy hematopoiesis and demonstrates that WT1 expression in PB is a useful post-treatment monitoring tool in childhood AML. Based on these observations, we propose definitions for childhood AML molecular relapse using WT1 overexpression.
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Affiliation(s)
| | - Charlotte Guldborg Nyvold
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark.,Hematology-Pathology Research Laboratory, Department of Hematology, Odense University Hospital, Odense, Denmark
| | - Helen Vålerhaugen
- Department of Pathology, The Norwegian Radium Hospital, Oslo, Norway
| | - Bernward Zeller
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Birgitte Lausen
- Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Hasle
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Hans Beier Ommen
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
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Zhang HY, Geng SX, Li MM, Lai PL, Deng CX, Lu ZS, Huang X, Wang YL, Weng JY, Du X. [Changes of WT1 mRNA expression level in patients with myelodysplastic syndromes after hypomethylating agents and its prognostic significance]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2019; 40:417-421. [PMID: 31207708 PMCID: PMC7342245 DOI: 10.3760/cma.j.issn.0253-2727.2019.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Indexed: 11/16/2022]
Abstract
Objective: To monitor the WT1 mRNA level and its dynamic changes in patients with myelodysplastic syndromes (MDS) after hypomethylating agents (HMA) , as well as to assess the significance of WT1 mRNA levels and its dynamic changes in evaluating the efficacy of HMA and distinguishing the disease status of heterogeneous patients with stable disease (SD) . Methods: Bone marrow or peripheral blood samples of 56 patients with MDS who underwent hypomethylating agents (≥4 cycles) from November 2009 to March 2018 were tested by real-time quantitative polymerase chain reaction (PCR) to detect the expression of WT1 mRNA, and to observe the correlation between the dynamic changes of WT1 mRNA expression and clinical efficacy and prognosis of patients. Results: WT1 mRNA expression levels of MDS patients decreased significantly after 3 cycles of hypomethylating agent treatment. Besides, the WT1 mRNA expression levels of patients increased significantly after diseases progression. According to the dynamic changes of WT1 mRNA expression levels during SD, 45 cases could be further divided into increased group and non-increased group. In those SD patients with increased WT1 mRNA expression level, the ratio of suffering disease progression or transformation to AML was 95.65% (22/23) , whereas the ratio turned to be 9.09% (2/22) for the non-increased group (χ(2)=33.852, P<0.001) . Compared with those SD patients reporting no increase in WT1 mRNA expression level, the overall survival[17 (95%CI 11-23) months vs not reached, P<0.001] and progression-free survival [13 (95%CI 8-18) months vs not reached, P<0.001] of those SD patients reporting increase in WT1 mRNA expression level were significantly shorter. Conclusion: WT1 mRNA expression level is a useful indicator to assess the efficacy of hypomethylating agents in MDS patients. Especially in patients with SD, detection of the changes in WT1 mRNA expression level is able to predict disease progression and help to make clinical decision.
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Affiliation(s)
- H Y Zhang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China; Guangdong Provincial People's Hospital/ Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Guangdong Institute of Geriatric Medicine, Guangzhou 510080, China
| | - S X Geng
- Guangdong Provincial People's Hospital/ Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Guangdong Institute of Geriatric Medicine, Guangzhou 510080, China
| | - M M Li
- Guangdong Provincial People's Hospital/ Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Guangdong Institute of Geriatric Medicine, Guangzhou 510080, China
| | - P L Lai
- Guangdong Provincial People's Hospital/ Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Guangdong Institute of Geriatric Medicine, Guangzhou 510080, China
| | - C X Deng
- Guangdong Provincial People's Hospital/ Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Guangdong Institute of Geriatric Medicine, Guangzhou 510080, China
| | - Z S Lu
- Guangdong Provincial People's Hospital/ Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Guangdong Institute of Geriatric Medicine, Guangzhou 510080, China
| | - X Huang
- Guangdong Provincial People's Hospital/ Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Guangdong Institute of Geriatric Medicine, Guangzhou 510080, China
| | - Y L Wang
- Guangdong Provincial People's Hospital/ Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Guangdong Institute of Geriatric Medicine, Guangzhou 510080, China
| | - J Y Weng
- Guangdong Provincial People's Hospital/ Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Guangdong Institute of Geriatric Medicine, Guangzhou 510080, China; School of Medicine, South China University of Technology, Guangzhou 510006, China
| | - X Du
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China; Guangdong Provincial People's Hospital/ Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Guangdong Institute of Geriatric Medicine, Guangzhou 510080, China; School of Medicine, South China University of Technology, Guangzhou 510006, China
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Mashima K, Ikeda T, Toda Y, Ito S, Umino K, Minakata D, Nakano H, Morita K, Yamasaki R, Kawasaki Y, Sugimoto M, Ashizawa M, Yamamoto C, Fujiwara S, Hatano K, Sato K, Oh I, Ohmine K, Muroi K, Kanda Y. Associations between the peripheral blood Wilms tumor gene 1 level and both bone marrow blast cells and the prognosis in patients with myelodysplastic syndrome. Leuk Lymphoma 2018; 60:703-710. [DOI: 10.1080/10428194.2018.1504940] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Kiyomi Mashima
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Takashi Ikeda
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Yumiko Toda
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Shoko Ito
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Kento Umino
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Daisuke Minakata
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Hirofumi Nakano
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Kaoru Morita
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Ryoko Yamasaki
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Yasufumi Kawasaki
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Miyuki Sugimoto
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Masahiro Ashizawa
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Chihiro Yamamoto
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Shinichiro Fujiwara
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Kaoru Hatano
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Kazuya Sato
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Iekuni Oh
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Ken Ohmine
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Kazuo Muroi
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke-shi, Japan
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Molecular Minimal Residual Disease Testing in Acute Myeloid Leukemia: A Review for the Practicing Clinician. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2018; 18:636-647. [PMID: 30006258 DOI: 10.1016/j.clml.2018.06.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/12/2018] [Accepted: 06/19/2018] [Indexed: 11/21/2022]
Abstract
Minimal residual disease (MRD) testing in acute myeloid leukemia is increasingly being used to assess treatment response and stratify the risk of relapse for individual patients. Molecular methods for MRD testing began with PCR-based assays for individual recurrent mutations. To date, there is robust evidence for testing NPM1, CBFB-MYH11, and RUNX1/RUNXT1 mutations using this approach, though the best timing and threshold level for each mutation varies. More recent approaches have been with PCR-based multigene panels, occasionally combined with flow cytometric techniques, and next-generation sequencing techniques. This review outlines the various techniques used in molecular approaches to MRD, the evidence behind individual mutation testing, and the novel approaches for evaluating multigene MRD so that clinicians can understand and incorporate these evaluations into their practice.
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12
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Koizumi Y, Furuya D, Endo T, Asanuma K, Yanagihara N, Takahashi S. Quantification of Wilms' tumor 1 mRNA by digital polymerase chain reaction. Int J Hematol 2017; 107:230-234. [PMID: 28994041 DOI: 10.1007/s12185-017-2336-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 09/25/2017] [Accepted: 09/26/2017] [Indexed: 10/18/2022]
Abstract
Wilms' tumor 1 (WT1) is overexpressed in various hematopoietic tumors and widely used as a marker of minimal residual disease. WT1 mRNA has been analyzed using quantitative real-time polymerase chain reaction (real-time PCR). In the present study, we analyzed 40 peripheral blood and bone marrow samples obtained from cases of acute myeloid leukemia, acute lymphoblastic leukemia, and myelodysplastic syndrome at Sapporo Medical University Hospital from April 2012 to January 2015. We performed quantification of WT1 was performed using QuantStudio 3D Digital PCR System (Thermo Fisher Scientific) and compared the results between digital PCR and real-time PCR technology. The correlation between digital PCR and real-time PCR was very strong (R = 0.99), and the detection limits of the two methods were equivalent. Digital PCR was able to accurately detect lower WT levels compared with real-time PCR. Digital PCR technology can thus be utilized to predict WT1/ABL1 expression level accurately and should thus be useful for diagnosis or the evaluation of drug efficiency in patients with leukemia.
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Affiliation(s)
- Yuki Koizumi
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan
| | - Daisuke Furuya
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan
| | - Teruo Endo
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan
| | - Kouichi Asanuma
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan
| | - Nozomi Yanagihara
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan.,Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Satoshi Takahashi
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan. .,Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.
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13
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Rampal R, Figueroa ME. Wilms tumor 1 mutations in the pathogenesis of acute myeloid leukemia. Haematologica 2017; 101:672-9. [PMID: 27252512 DOI: 10.3324/haematol.2015.141796] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 04/05/2016] [Indexed: 12/30/2022] Open
Abstract
Wilms tumor 1 (WT1) has long been implicated in acute myeloid leukemia. It has been described to be both overexpressed and mutated in different forms of acute myeloid leukemia, and overexpression has been reported to play a prognostic role in this disease. However, the precise mechanism through which WT1 may play a role in leukemogenesis has remained elusive. In recent years, new evidence has emerged that points towards a novel role of WT1 mutations in the deregulation of epigenetic programs in leukemic cells through its interaction with TET proteins. Herein we review the current status of the field and its therapeutic and prognostic implications in acute myeloid leukemia.
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Affiliation(s)
- Raajit Rampal
- Leukemia Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maria E Figueroa
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
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14
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Ogata K. WT1 Expression in Patients with Myelodysplastic Syndromes: A Variety of Possibilities in Future Clinical Practice. Acta Haematol 2016; 137:30-31. [PMID: 27871071 DOI: 10.1159/000449363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 08/07/2016] [Indexed: 01/13/2023]
Affiliation(s)
- Kiyoyuki Ogata
- Metropolitan Research and Treatment Center for Blood Disorders (MRTC Japan), Tokyo, Japan
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15
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Nagasaki J, Aoyama Y, Hino M, Ido K, Ichihara H, Manabe M, Ohta T, Mugitani A. Wilms Tumor 1 (WT1) mRNA Expression Level at Diagnosis Is a Significant Prognostic Marker in Elderly Patients with Myelodysplastic Syndrome. Acta Haematol 2016; 137:32-39. [PMID: 27866185 DOI: 10.1159/000452732] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 10/17/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND/AIMS A high expression of Wilms tumor 1 (WT1) mRNA occurs in most cases of acute leukemia and myelodysplastic syndrome (MDS). Although there are many reports suggesting that acute myeloid leukemia patients with high expression levels of WT1 mRNA have a relatively poor long-term survival, there are few reports addressing the relationship between WT1 levels and prognosis in MDS. METHODS We retrospectively analyzed 42 elderly patients with MDS whose WT1 levels at diagnosis were available, and we assessed the relationships between WT1 levels in peripheral blood and preexisting prognostic factors such as World Health Organization prognostic scores and Revised International Prognostic Scoring System risk categories, bone marrow blast percentages, and chromosomal abnormalities linked to a poor prognosis. We also evaluated the relationship between WT1 levels and prognosis. RESULTS WT1 levels were significantly different between high- and low-risk MDS patients (p < 0.05). There was a trend towards a significant difference between those with and those without poor prognostic chromosomal rearrangements (p = 0.051). Moreover, the overall survival and progression-free survival were significantly worse in elderly patients with higher levels of WT1 (p = 0.00039 and p = 0.00077, respectively). CONCLUSIONS The WT1 mRNA expression level at diagnosis may be a significant independent prognostic marker for elderly patients with MDS.
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Affiliation(s)
- Joji Nagasaki
- Department of Hematology, Seichokai Fuchu Hospital, Osaka, Japan
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16
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Picciolini S, Mehn D, Morasso C, Vanna R, Bedoni M, Pellacani P, Marchesini G, Valsesia A, Prosperi D, Tresoldi C, Ciceri F, Gramatica F. Polymer nanopillar-gold arrays as surface-enhanced Raman spectroscopy substrate for the simultaneous detection of multiple genes. ACS NANO 2014; 8:10496-10506. [PMID: 25280123 DOI: 10.1021/nn503873d] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In our study, 2D nanopillar arrays with plasmonic crystal properties are optimized for surface-enhanced Raman spectroscopy (SERS) application and tested in a biochemical assay for the simultaneous detection of multiple genetic leukemia biomarkers. The special fabrication process combining soft lithography and plasma deposition techniques allows tailoring of the structural and chemical parameters of the crystal surfaces. In this way, it has been possible to tune the plasmonic resonance spectral position close to the excitation wavelength of the monochromatic laser light source in order to maximize the enhancing properties of the substrate. Samples are characterized by scanning electron microscopy and reflectance measurements and tested for SERS activity using malachite green. Besides, as the developed substrate had been prepared on a simple glass slide, SERS detection from the support side is also demonstrated. The optimized substrate is functionalized with thiol-modified capture oligonucleotides, and concentration-dependent signal of the target nucleotide is detected in a sandwich assay with labeled gold nanoparticles. Gold nanoparticles functionalized with different DNA and various Raman reporters are applied in a microarray-based assay recognizing a disease biomarker (Wilms tumor gene) and housekeeping gene expressions in the same time on spatially separated microspots. The multiplexing performance of the SERS-based bioassay is illustrated by distinguishing Raman dyes based on their complex spectral fingerprints.
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Affiliation(s)
- Silvia Picciolini
- Fondazione Don Carlo Gnocchi ONLUS , Piazzale Morandi 6, 20121 Milan, Italy
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17
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Uttenthal B, Martinez-Davila I, Ivey A, Craddock C, Chen F, Virchis A, Kottaridis P, Grimwade D, Khwaja A, Stauss H, Morris EC. Wilms' Tumour 1 (WT1) peptide vaccination in patients with acute myeloid leukaemia induces short-lived WT1-specific immune responses. Br J Haematol 2013; 164:366-75. [PMID: 24422723 PMCID: PMC4253125 DOI: 10.1111/bjh.12637] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 09/06/2013] [Indexed: 12/04/2022]
Abstract
Wilms’ Tumour 1 (WT1) is a zinc finger transcription factor that is over-expressed in acute myeloid leukaemia (AML). Its restricted expression in normal tissues makes it a promising target for novel immunotherapies aiming to accentuate the cytotoxic T lymphocyte (CTL) response against AML. Here we report a phase I/II clinical trial of subcutaneous peptide vaccination with two separate HLA-A2-binding peptide epitopes derived from WT1, together with a pan-DR binding peptide epitope (PADRE), in Montanide adjuvant. Eight HLA-A2-positive patients with poor risk AML received five vaccination cycles at 3-weekly intervals. The three cohorts received 0·3, 0·6 and 1 mg of each peptide, respectively. In six patients, WT1-specific CTL responses were detected using enzyme-linked immunosorbent spot assays and pWT126/HLA-A*0201 tetramer staining, after ex vivo stimulation with the relevant WT1 peptides. However, re-stimulation of these WT1-specific T cells failed to elicit secondary expansion in all four patients tested, suggesting that the WT1-specific CD8+ T cells generated following vaccination may be functionally impaired. No correlation was observed between peptide dose, cellular immune response, reduction in WT1mRNA expression and clinical response. Larger studies are indicated to confirm these findings.
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Affiliation(s)
- Benjamin Uttenthal
- UCL Division of Infection and Immunity, Department of Immunology, University College London, London, UK
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18
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Qin YZ, Zhu HH, Liu YR, Wang YZ, Shi HX, Lai YY, Xu LP, Liu DH, Jiang Q, Li LD, Jiang B, Liu KY, Huang XJ. PRAME and WT1 transcripts constitute a good molecular marker combination for monitoring minimal residual disease in myelodysplastic syndromes. Leuk Lymphoma 2012; 54:1442-9. [PMID: 23110703 DOI: 10.3109/10428194.2012.743656] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
| | | | - Yan-Rong Liu
- Peking University People's Hospital, Peking University Institute of Hematology,
Beijing, China
| | - Ya-Zhe Wang
- Peking University People's Hospital, Peking University Institute of Hematology,
Beijing, China
| | - Hong-Xia Shi
- Peking University People's Hospital, Peking University Institute of Hematology,
Beijing, China
| | - Yue-Yun Lai
- Peking University People's Hospital, Peking University Institute of Hematology,
Beijing, China
| | - Lan-Ping Xu
- Peking University People's Hospital, Peking University Institute of Hematology,
Beijing, China
| | - Dai-Hong Liu
- Peking University People's Hospital, Peking University Institute of Hematology,
Beijing, China
| | - Qian Jiang
- Peking University People's Hospital, Peking University Institute of Hematology,
Beijing, China
| | - Ling-Di Li
- Peking University People's Hospital, Peking University Institute of Hematology,
Beijing, China
| | - Bin Jiang
- Peking University People's Hospital, Peking University Institute of Hematology,
Beijing, China
| | - Kai-Yan Liu
- Peking University People's Hospital, Peking University Institute of Hematology,
Beijing, China
| | - Xiao-Jun Huang
- Peking University People's Hospital, Peking University Institute of Hematology,
Beijing, China
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19
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Ueda Y, Mizutani C, Nannya Y, Kurokawa M, Kobayashi S, Takeuchi J, Tamura H, Ogata K, Dan K, Shibayama H, Kanakura Y, Niimi K, Sasaki K, Watanabe M, Emi N, Teramura M, Motoji T, Kida M, Usuki K, Takada S, Sakura T, Ito Y, Ohyashiki K, Ogawa H, Suzuki T, Ozawa K, Imai K, Kasai M, Hata T, Miyazaki Y, Morita Y, Kanamaru A, Matsuda A, Tohyama K, Koga D, Tamaki H, Mitani K, Naoe T, Sugiyama H, Takaku F. Clinical evaluation of WT1 mRNA expression levels in peripheral blood and bone marrow in patients with myelodysplastic syndromes. Leuk Lymphoma 2012; 54:1450-8. [DOI: 10.3109/10428194.2012.745074] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Yasunori Ueda
- Department of Hematology/Oncology, Transfusion and Hemapheresis Center, Kurashiki Central Hospital,
Okayama, Japan
| | - Chisato Mizutani
- Department of Hematology/Oncology, Transfusion and Hemapheresis Center, Kurashiki Central Hospital,
Okayama, Japan
| | - Yasuhito Nannya
- Department of Hematology and Oncology, University of Tokyo Graduate School of Medicine,
Tokyo, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, University of Tokyo Graduate School of Medicine,
Tokyo, Japan
| | - Sumiko Kobayashi
- Department of Hematology and Rheumatology, Nihon University School of Medicine,
Tokyo, Japan
| | - Jin Takeuchi
- Department of Hematology and Rheumatology, Nihon University School of Medicine,
Tokyo, Japan
| | - Hideto Tamura
- Division of Hematology, Department of Medicine, Nippon Medical School,
Tokyo, Japan
| | - Kiyoyuki Ogata
- Division of Hematology, Department of Medicine, Nippon Medical School,
Tokyo, Japan
| | - Kazuo Dan
- Division of Hematology, Department of Medicine, Nippon Medical School,
Tokyo, Japan
| | - Hirohiko Shibayama
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine,
Osaka, Japan
| | - Yuzuru Kanakura
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine,
Osaka, Japan
| | - Keiko Niimi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine,
Nagoya, Japan
| | - Ko Sasaki
- Department of Hematology and Oncology, Dokkyo Medical University Hospital,
Tochigi, Japan
| | - Masato Watanabe
- Department of Hematology, Fujita Health University School of Medicine,
Aichi, Japan
| | - Nobuhiko Emi
- Department of Hematology, Fujita Health University School of Medicine,
Aichi, Japan
| | - Masanao Teramura
- Department of Hematology, Tokyo Women's Medical University,
Tokyo, Japan
| | - Toshiko Motoji
- Department of Hematology, Tokyo Women's Medical University,
Tokyo, Japan
| | - Michiko Kida
- Division of Hematology, NTT Kanto Medical Center,
Tokyo, Japan
| | - Kensuke Usuki
- Division of Hematology, NTT Kanto Medical Center,
Tokyo, Japan
| | - Satoru Takada
- Department of Hematology, Saiseikai Maebashi Hospital,
Gunma, Japan
| | - Toru Sakura
- Department of Hematology, Saiseikai Maebashi Hospital,
Gunma, Japan
| | - Yoshikazu Ito
- Division of Hematology, Tokyo Medical University Hospital,
Tokyo, Japan
| | - Kazuma Ohyashiki
- Division of Hematology, Tokyo Medical University Hospital,
Tokyo, Japan
| | - Hiroyasu Ogawa
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine,
Hyogo, Japan
| | - Takahiro Suzuki
- Division of Hematology, Department of Medicine, Jichi Medical University,
Tochigi, Japan
| | - Keiya Ozawa
- Division of Hematology, Department of Medicine, Jichi Medical University,
Tochigi, Japan
| | - Kiyotoshi Imai
- Department of Hematology, Sapporo Hokuyu Hospital,
Sapporo, Japan
| | - Masaharu Kasai
- Department of Hematology, Sapporo Hokuyu Hospital,
Sapporo, Japan
| | - Tomoko Hata
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences,
Nagasaki, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences,
Nagasaki, Japan
| | - Yasuyoshi Morita
- Division of Hematology, Kinki University School of Medicine,
Osaka, Japan
| | - Akihisa Kanamaru
- Division of Hematology, Kinki University School of Medicine,
Osaka, Japan
| | - Akira Matsuda
- Department of Hemato-Oncology, Saitama International Medical Center, Saitama Medical University,
Saitama, Japan
| | - Kaoru Tohyama
- Department of Laboratory Medicine, Kawasaki Medical School,
Okayama, Japan
| | - Daisuke Koga
- Diagnostic Division, Otsuka Pharmaceutical Co., Ltd.,
Tokushima, Japan
| | - Hiroya Tamaki
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine,
Hyogo, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University Hospital,
Tochigi, Japan
| | - Tomoki Naoe
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine,
Nagoya, Japan
| | - Haruo Sugiyama
- Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine,
Osaka, Japan
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Abstract
In acute myeloid leukemia (AML), aberrant expression and mutations of transcription factors have been correlated with disease outcome. In the present study, we performed expression and mutation screening of GATA2, which is an essential transcription factor for regulation of myeloid lineage determination, in de novo pediatric AML patients. GATA2 mutations were detected in 5 of 230 patients, representing a frequency of 2.2% overall and 9.8% in cytogenetically normal AML. GATA2 expression analysis demonstrated that in 155 of 237 diagnostic samples (65%), GATA2 expression was higher than in normal BM. In complete remission, normalization of GATA2 expression was observed, whereas GATA2 expression levels stayed high in patients with resistant disease. High GATA2 expression at diagnosis was an independent poor prognostic factor for overall survival (hazard ratio [HR] = 1.7, P = .045), event-free survival (HR = 2.1, P = .002), and disease-free survival (HR = 2.3, P = .004). The prognostic impact of GATA2 was particularly evident in specific AML subgroups. In patients with French-American-British M5 morphology, inv(16), or high WT1 expression, significant differences in survival were observed between patients with high versus normal GATA2 expression. We conclude that high GATA2 expression is a novel poor prognostic marker in pediatric AML, which may contribute to better risk-group stratification and risk-adapted therapy in the future.
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21
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Prognostic significance of WT1 mRNA and anti-WT1 antibody levels in peripheral blood in patients with myelodysplastic syndromes. Leuk Res 2010; 34:986-90. [DOI: 10.1016/j.leukres.2009.11.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Revised: 11/14/2009] [Accepted: 11/28/2009] [Indexed: 12/18/2022]
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22
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Gianfaldoni G, Mannelli F, Ponziani V, Longo G, Bencini S, Bosi A, Vannucchi AM. Early reduction of WT1 transcripts during induction chemotherapy predicts for longer disease free and overall survival in acute myeloid leukemia. Haematologica 2010; 95:833-6. [PMID: 20107153 DOI: 10.3324/haematol.2009.011908] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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 real-time quantitative PCR in peripheral blood on days 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 greater than 5.82 (i.e. the median value of whole cohort) than in patients with WT1 ratio of 5.82 or under (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 should be considered in the management of AML patients.
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Affiliation(s)
- Giacomo Gianfaldoni
- UF di Ematologia, Dipartimento di Area Critica Medico-Chirurgica, Università degli Studi, Firenze, Italy
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23
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Cilloni D, Renneville A, Hermitte F, Hills RK, Daly S, Jovanovic JV, Gottardi E, Fava M, Schnittger S, Weiss T, Izzo B, Nomdedeu J, van der Heijden A, van der Reijden BA, Jansen JH, van der Velden VHJ, Ommen H, Preudhomme C, Saglio G, Grimwade D. Real-time quantitative polymerase chain reaction detection of minimal residual disease by standardized WT1 assay to enhance risk stratification in acute myeloid leukemia: a European LeukemiaNet study. J Clin Oncol 2009; 27:5195-201. [PMID: 19752335 DOI: 10.1200/jco.2009.22.4865] [Citation(s) in RCA: 343] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Risk stratification in acute myeloid leukemia (AML) is currently based on pretreatment characteristics. It remains to be established whether relapse risk can be better predicted through assessment of minimal residual disease (MRD). One proposed marker is the Wilms tumor gene WT1, which is overexpressed in most patients with AML, thus providing a putative target for immunotherapy, although in the absence of a standardized assay, its utility for MRD monitoring remains controversial. PATIENTS AND METHODS Nine published and in-house real-time quantitative polymerase chain reaction WT1 assays were systematically evaluated within the European LeukemiaNet; the best-performing assay was applied to diagnostic AML samples (n = 620), follow-up samples from 129 patients treated with intensive combination chemotherapy, and 204 normal peripheral blood (PB) and bone marrow (BM) controls. RESULTS Considering relative levels of expression detected in normal PB and BM, WT1 was sufficiently overexpressed to discriminate > or = 2-log reduction in transcripts in 46% and 13% of AML patients, according to the respective follow-up sample source. In this informative group, greater WT1 transcript reduction after induction predicted reduced relapse risk (hazard ratio, 0.54 per log reduction; 95% CI, 0.36 to 0.83; P = .004) that remained significant when adjusted for age, WBC count, and cytogenetics. Failure to reduce WT1 transcripts below the threshold limits defined in normal controls by the end of consolidation also predicted increased relapse risk (P = .004). CONCLUSION Application of a standardized WT1 assay provides independent prognostic information in AML, lending support to incorporation of early assessment of MRD to develop more robust risk scores, to enhance risk stratification, and to identify patients who may benefit from allogeneic transplantation.
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Affiliation(s)
- Daniela Cilloni
- Department of Clinical and Biological Sciences, University of Turin, Turin
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24
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Abstract
AbstractWilms tumor 1 (WT1) mutations have recently been identified in approximately 10% of adult acute myeloid leukemia (AML) with normal cytogenetics (CN-AML) and are associated with poor outcome. Using array-based comparative genome hybridization in pediatric CN-AML samples, we detected a WT1 deletion in one sample. The other WT1 allele was mutated. This prompted us to further investigate the role of WT1 aberrations in childhood AML. Mutations were found in 35 of 298 (12%) diagnostic pediatric AML samples. In 19 of 35 (54%) samples, more than one WT1 aberration was found: 15 samples had 2 different mutations, 2 had a homozygous mutation, and 2 had a mutation plus a WT1 deletion. WT1 mutations clustered significantly in the CN-AML subgroup (22%; P < .001) and were associated with FLT3/ITD (43 vs 17%; P < .001). WT1 mutations conferred an independent poor prognostic significance (WT1 mutated vs wild-type patients: 5-year probability of overall survival [pOS] 35% vs 66%, P = .002; probability of event-free survival 22% vs 46%, P < .001; and cumulative incidence of relapse or regression 70% vs 44%, P < .001). Patients with both a WT1 mutation and a FLT3/ITD had a dismal prognosis (5-year pOS 21%). WT1 mutations occur at a significant rate in childhood AML and are a novel independent poor prognostic marker.
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25
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Kerst G, Bergold N, Viebahn S, Gieseke F, Kalinova M, Trka J, Handgretinger R, Müller I. WT1 protein expression in slowly proliferating myeloid leukemic cell lines is scarce throughout the cell cycle with a minimum in G0/G1 phase. Leuk Res 2008; 32:1393-9. [PMID: 18457871 DOI: 10.1016/j.leukres.2008.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Revised: 03/03/2008] [Accepted: 03/10/2008] [Indexed: 11/26/2022]
Abstract
Wilms' tumor gene 1 (WT1) is overexpressed in various hematological malignancies and has been proposed as a target for minimal residual disease (MRD) detection and for immunotherapy. Although WT1 is known as a key molecule for tumor cell proliferation, the expression pattern of WT1 in leukemic cells in dependency of proliferation has not yet been investigated. Furthermore, WT1 expression was mostly studied by reverse transcriptase PCR and the expression of WT1 protein has not been extensively studied. Here, we analyzed WT1 protein expression in the human myeloid leukemia cell lines K562 and HL-60 by indirect immunofluorescence and flow cytometry. Both cell lines exhibited varying nuclear WT1 immunoreactivity pointing to a cell cycle-dependent and/or proliferation-dependent WT1 expression. In rapidly proliferating cells high levels of WT1 protein were detected by flow cytometry. A reduced proliferation rate was associated with a low WT1 protein expression and an accumulation of cells in G(0)/G(1) phase. During G(0)/G(1) phase cells expressed WT1 at a lower level than in S or G(2)/M phase. Moreover, WT1 expression was diminished in all cell cycle phases in slowly proliferating cells. We conclude that WT1 protein expression is dependent on the cell cycle phase as well as on the proliferation rate. This finding might be relevant for MRD studies and immunotherapeutic strategies targeting WT1.
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Affiliation(s)
- Gunter Kerst
- Department of Pediatric Cardiology, University Children's Hospital Tuebingen, Hoppe-Seyler-Str. 1, 72076 Tuebingen, Germany.
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26
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Kerst G, Bergold N, Gieseke F, Coustan-Smith E, Lang P, Kalinova M, Handgretinger R, Trka J, Müller I. WT1 protein expression in childhood acute leukemia. Am J Hematol 2008; 83:382-6. [PMID: 18161786 DOI: 10.1002/ajh.21123] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In patients with acute leukemia, Wilms' tumor gene 1 (WT1) has been used as a target for the detection of minimal residual disease (MRD) by PCR techniques. The expression of WT1 protein, however, has not been extensively studied. To determine the relation between expression of WT1 transcripts and of the encoded protein, we examined leukemic cell lines and primary childhood leukemia samples using both real-time quantitative PCR (RQ-PCR) and flow cytometry. WT1 protein was highly expressed in the leukemic cell lines K562, HL-60, PLB 985, KG-1a and CEM. By contrast, 40 primary samples of acute lymphoblastic leukemia (ALL; B-ALL, n = 15 and T-ALL, n = 10) and acute myeloid leukemia (n = 15) expressed low levels of WT1 protein. RQ-PCR detected WT1 transcript levels in the same range as reported in earlier studies in childhood acute leukemia. The results of this study indicate the following: (i) there are considerable discrepancies between WT1 transcripts and protein expression; (ii) WT1 is not a suitable marker for flow cytometric MRD detection in childhood acute leukemia.
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MESH Headings
- Adolescent
- Adult
- Biomarkers, Tumor
- Blood Cells/metabolism
- Bone Marrow Cells/metabolism
- Burkitt Lymphoma/genetics
- Burkitt Lymphoma/metabolism
- Burkitt Lymphoma/pathology
- Cell Line, Tumor/metabolism
- Child
- Child, Preschool
- Female
- Flow Cytometry
- Gene Expression Regulation, Leukemic
- Genes, Wilms Tumor
- Humans
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/metabolism
- Leukemia-Lymphoma, Adult T-Cell/genetics
- Leukemia-Lymphoma, Adult T-Cell/metabolism
- Leukemia-Lymphoma, Adult T-Cell/pathology
- Male
- Neoplasm Proteins/analysis
- Neoplasm Proteins/biosynthesis
- Neoplasm Proteins/genetics
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/metabolism
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology
- RNA, Messenger/biosynthesis
- RNA, Neoplasm/biosynthesis
- Sensitivity and Specificity
- WT1 Proteins/analysis
- WT1 Proteins/biosynthesis
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Affiliation(s)
- Gunter Kerst
- Department of Pediatric Cardiology, University Children's Hospital, Tuebingen, Germany.
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Castro-Malaspina H, Jabubowski AA, Papadopoulos EB, Boulad F, Young JW, Kernan NA, Perales MA, Small TN, Hsu K, Chiu M, Heller G, Collins NH, Jhanwar SC, van den Brink M, Nimer SD, O'Reilly RJ. Transplantation in remission improves the disease-free survival of patients with advanced myelodysplastic syndromes treated with myeloablative T cell-depleted stem cell transplants from HLA-identical siblings. Biol Blood Marrow Transplant 2008; 14:458-68. [PMID: 18342789 DOI: 10.1016/j.bbmt.2008.02.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Accepted: 02/06/2008] [Indexed: 11/28/2022]
Abstract
From 1985 to 2004, 49 patients with advanced myelodysplastic syndromes (MDS) (> or =5% blasts) or acute myeloid leukemia (AML) transformed from MDS underwent T cell depleted bone marrow or peripheral blood hematopoietic stem cell transplantation (HSCT) from HLA-identical siblings following conditioning with a myeloablative regimen that included total body irradiation (44 patients) or busulfan (5 patients). Thirty-six patients received chemotherapy (3 low dose and 33 induction doses) before conditioning, and 13 patients did not receive any chemotherapy. Prior to transplantation, 22 of the 36 treated patients were in hematologic remission; 4 were in a second refractory cytopenia phase (26 responders); 8 had failed to achieve remission; and 2 of the responders had progression or relapse of their MDS (10 failures). No post-transplantation pharmacologic prophylaxis for graft-versus-host disease (GVHD) was given. The median age was 48 yrs (range 13-61). Forty-five of the 49 patients engrafted; 2 had primary graft failure; and 2 died before engraftment. Only 3 patients developed acute GVHD (aGVHD) (grades I and III) and 1 chronic GVHD (cGVHD). At 3 yrs post-transplantation, the overall survival (OS) was 54% in the responders; 31% in the untreated group; and 0% in the failure group (P=.0004). The disease free survival (DFS) was 50%, 15% and 0% in each group respectively (P=.0008). In multivariate analysis, disease status before cytoreduction remained highly correlated with DFS (P<.001). The cumulative incidence (CI) of relapse at 2-yrs post-transplantation for the responders was 23%; for the untreated group was 38%; and for the failures was 50%. The CI of non-relapse mortality at 2-yrs post-transplantation, for the responders was 23%; for the untreated group was 38%; and for the failures was 40%. All survivors achieved a Karnofsky Performance Status (KPS) of > or =90. These results indicate that patients with advanced MDS who achieve and remain in remission or a second refractory cytopenia phase with chemotherapy before conditioning can achieve successful long-term remissions following a myeloablative T cell depleted allogeneic HSCT.
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Affiliation(s)
- Hugo Castro-Malaspina
- The Allogeneic Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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Keilholz U. Antigen-specific cancer vaccines. RECENT RESULTS IN CANCER RESEARCH. FORTSCHRITTE DER KREBSFORSCHUNG. PROGRES DANS LES RECHERCHES SUR LE CANCER 2007; 176:213-8. [PMID: 17607928 DOI: 10.1007/978-3-540-46091-6_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The past decade has seen a number of clinical vaccination trials investigating defined tumor antigens. These trials have taught us the immunologic consequences of various vaccination approaches, although the clinical efficacy of the vaccines has only reached the proof-of-concept level. Detailed and rigorous immune monitoring will be crucial for successful further development of cancer vaccines as well as defining patient populations likely to benefit. At a recent meeting of the Berlin Oncology Summer Seminar (BOSS) the clinical and translational cancer vaccine program ongoing at the Charité was presented, and this paper contains a summary of the presentation as well as the subsequent discussion.
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Affiliation(s)
- Ulrich Keilholz
- Department of Medicine III, Charité Campus Benjamin Franklin, Berlin, Germany
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Keilholz U, Menssen HD, Gaiger A, Menke A, Oji Y, Oka Y, Scheibenbogen C, Stauss H, Thiel E, Sugiyama H. Wilms' tumour gene 1 (WT1) in human neoplasia. Leukemia 2005; 19:1318-23. [PMID: 15920488 DOI: 10.1038/sj.leu.2403817] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The transcription factor Wilms' tumour gene 1 (WT1) is important as a prognostic marker as well as in the detection and monitoring of minimal residual disease in leukaemia and myelodysplastic syndromes. Evidence has accumulated over the past decade to show that WT1 is a key molecule for tumour proliferation in a large number of human neoplasms most prominent in acute leukaemias, making it a suitable target for therapeutic strategies. Based on animal results, showing safety and efficacy of immunization with WT1 peptides and protein, early clinical trials in leukaemia have recently been initiated. The First International Conference on WT1 in Human Neoplasia was held in Berlin, March 11--12, 2004. This report reviews the current knowledge on the role of WT1 in tumour promotion and as a diagnostic and therapeutic target, and summarizes the data presented and discussed in this meeting.
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Affiliation(s)
- U Keilholz
- Department of Medicine III, Charité, Campus Benjamin Franklin, Berlin, Germany.
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van Dijk JP, de Witte T. Monitoring treatment efficiency in MDS at the molecular level; possibilities now and in the future. Leuk Res 2004; 28:101-8. [PMID: 14654071 DOI: 10.1016/s0145-2126(03)00186-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Myelodysplastic syndromes (MDS) are a heterogeneous group of bone marrow (BM) diseases. MDS patients suffer from bone marrow failure because of the expansion of a malignant clone, resulting in abnormal differentiation of blood cells and severe pancytopenias. MDS patients have a high propensity for the development of acute myeloid leukemia (AML). During the last few years it has become increasingly clear that MDS is a stem cell disease. Two methods have generally been used to study the clonal origin of MDS bone marrow cells. First, the combination of fluorescent in situ hybridization (FISH) in combination with cell sorting has been used to study MDS specific numerical chromosomal aberrations in various cell types. Secondly, the determination of the X-chromosome inactivation patterns (XCIP) in different cell types of female MDS patients has been used to study clonality irrespective of the presence of a disease-specific marker. Both techniques have also been used to monitor treatment efficiency. Both methods showed that a molecular remission occurred in approximately half of the patients who achieved complete clinical remission after intensive antileukemic treatment, depending on the study and the type of treatment. In case of cytogenetic analysis this proved to be of prognostic significance. This review discusses the advantages and disadvantages of both techniques for the determination of clonality at diagnosis as well as for the assessment of treatment efficiency in past and in ongoing clinical trials. Future directions and possibilities for further research are also discussed.
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Affiliation(s)
- Jeroen P van Dijk
- Central Hematology Laboratory, University Medical Center Nijmegen, Nijmegen, The Netherlands
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Rosenfeld C, Cheever MA, Gaiger A. WT1 in acute leukemia, chronic myelogenous leukemia and myelodysplastic syndrome: therapeutic potential of WT1 targeted therapies. Leukemia 2003; 17:1301-12. [PMID: 12835718 DOI: 10.1038/sj.leu.2402988] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Among clinicians, initial awareness of the Wilms' tumor gene was limited mostly to pediatric oncologists. Almost a decade ago, overexpression of Wilms' tumor 1 (WT1) was observed in adult acute leukemia. Subsequent studies indicated that WT1 overexpression occurs in most cases of acute myelogenous leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia (CML), and myelodysplastic syndrome (MDS). Limited tissue expression of WT1 in adults suggests that WT1 can be a target for leukemia/MDS therapy. WT1 expression in stem/progenitor cells remains unsettled. However, lack of progenitor cell suppression by WT1 antisense or WT1-specific cytotoxic T cells provide some assurance that WT1 expression in progenitor cells is minimal or absent. Immunotherapy-based WT1 approaches are furthest along in preclinical development. WT1-specific cytotoxic lymphocytes can be generated from normals and leukemic patients. In mice, WT1 vaccines elicit specific immune responses without evidence of tissue damage. In this paper, we review studies validating the immunogenicity of WT1 and propose that leukemia and MDS may be a good clinical model to test the efficacy of a WT1 vaccine.
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