Prognostic value of combined WT1 and multiparameter flow cytometry assessment for measurable residual disease after induction in non-APL acute myeloid leukemia.

The objective of this study was to investigate the expression pattern of Wilms tumor 1 (WT1) gene at diagnosis, complete remission (CR) and relapse status in non-acute promyelocytic leukemia (non-APL) acute myeloid leukemia (AML) patients, and further explore the prognostic value of measurable residual disease (MRD) assessment by WT1 gene and multiparameter flow cytometry (MFC). Our results showed that the average expression level of WT1 was 4026 ± 616.1 copies/104 ABL at diagnosis, 155.3 ± 36.03 copies/104 ABL at CR, and 1766 ± 238.8 copies/104 ABL at relapse, with statistically significant differences (p = .000). ROC analysis showed that WT1 expression levels were 118.1 copies/104 ABL and MFC-MRD was 0.155%, which had good predictive efficacy for relapse of patients during consolidation therapy. Both WT1-MRD and MFC-MRD had a significant impact on relapse-free survival (RFS) and overall survival (OS). Patients with WT1-MRD positive or MFC-MRD positive were associated with worse RFS (HR 3.840, 95% CI 1.582-9.320, p = .003), (HR 4.464, 95% CI 1.841-10.984, p = .001) and worse OS (HR 2.963, 95% CI 1.058-8.295, p = .039), (HR 3.590, 95% CI 1.254-10.280, p = .017). Besides, compared with patients who were negative for both WT1-MRD and MFC-MRD, patients who were positive both WT1-MRD and MFC-MRD were associated with worse RFS (HR 6.200, 95% CI 2.206-17.430, p = .001) and worse OS (HR 4.886, 95% CI 1.388-17.197, p = .013). This study demonstrates that combined assessment of MRD by WT1 and MFC improves relapse and prognosis prediction in non-APL AML patients, and may help guide interventions for disease relapse.

Spatial Response of Ecosystem Service Value to Urbanization in Fragile Vegetation Areas Based on Terrain Gradient.

The contradiction between urban expansion and ecological protection in fragile vegetation areas has become increasingly prominent with regional development. Revealing the relationship between urbanization and ecosystem services will help to provide solutions to this problem. In order to clarify the impact of urbanization on typical mountain areas with fragile vegetation on the Qinghai Tibet Plateau, we built an ecosystem service value (ESV) evaluation index system. We also evaluated the ESV and its spatial response to the urbanization of Shannan Prefecture in Tibet from 1990 to 2015 based on different terrain gradients (TGs) using vegetation biophysical data obtained from remote sensing platforms. The results show that ESV in Shannan increased first and then declined as the TG increased, reaching a maximum value at the third TG. ESV showed a decreased trend during the study period, with a significant decline at the second and third TGs, which were the main distribution areas of vegetation in Shannan. Through spatial correlation analysis, we observed that urbanization and ESV showed a significant spatial aggregation effect. Among them, the high-low type accounted for the largest proportion in the grid with the agglomeration effect, mainly concentrated at the lower TG in the southern of Shannan, where ESV decreases with the increasing urbanization. We highlight the need for targeted, sustainable development policies to rationally organize the urbanization process in the different-gradient plateau regions with fragile vegetation. These results can provide a reference for applying ESV to vegetation restoration and ecological protection in ecologically fragile mountain areas.