Subgroup Analysis Can Optimize the Relapse Prediction Cutoff Value for WT1 Expression Following Allogeneic Hematologic Stem Cell Transplantation in Acute Myeloid Leukemia

Publication date: Available online 18 November 2019Source: The Journal of Molecular DiagnosticsAuthor(s): Ya-Zhen Qin, Yu Wang, Lan-Ping Xu, Xiao-Hui Zhang, Xiao-Su Zhao, Kai-Yan Liu, Xiao-Jun HuangHigh WT1 expression after allogeneic hematologic stem cell transplantation (allo-HSCT) can strongly predict relapse in acute myeloid leukemia (AML). However, the cutoff values obtained were inconsistent. The precise cutoff values may be optimized through subtype analysis, and the RUNX1-RUNX1T1 fusion transcript provides an ideal reference. RUNX1-RUNX1T1 and WT1 transcript levels were simultaneously measured in 1,299 bone marrow samples serially collected from 176 t(8;21) AML patients after receiving allo-HSCTfor. The upper limit of the normal bone marrow WT1 level was 0.6%, previously reported to be the cutoff value for significant relapse prediction in AML as a whole. The cutoff values 0.6%, 1.2%, and 1.8% for WT1 significantly differentiated patients in relapse after allo-HSCT. Nevertheless, both patients with WT1 levels 0.6% to 1.2% and those with levels between 1.2% to 1.8% post-HSCT had a similar cumulative incidence of relapse rates as those with a continuous WT1 level ≤0.6% and both were significantly lower than that of patients with a WT1 level>1.8%. WT1 expression was significantly related to the RUNX1-RUNX1T1 transcript levels at WT1 levels>1.8% but not at levels 0.6% to 1.2% and 1.2% to 1.8%. Therefore, subgroup analysis can optimize the relapse prediction cutoff value...
Source: The Journal of Molecular Diagnostics - Category: Pathology Source Type: research