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WT1-mutated acute myeloid leukemia is sensitive to fludarabine-based chemotherapy and conditioning regimens.
Aribi, Ahmed; Salhotra, Amandeep; Afkhami, Michelle; Munteanu, Anamaria; Ali, Haris; Aldoss, Ibrahim; Otoukesh, Salman; Al Malki, Monzr M; Sandhu, Karamjeet S; Koller, Paul; Arslan, Shukaib; Stewart, Forrest; Artz, Andrew; Curtin, Peter; Ball, Brian; O'Hearn, James; Spielberger, Ricardo; Smith, Eileen; Budde, Elizabeth; Nakamura, Ryotaro; Stein, Anthony; Forman, Stephen; Marcucci, Guido; Becker, Pamela S; Pullarkat, Vinod.
Affiliation
  • Aribi A; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Salhotra A; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Afkhami M; Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA.
  • Munteanu A; Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA.
  • Ali H; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Aldoss I; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Otoukesh S; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Al Malki MM; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Sandhu KS; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Koller P; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Arslan S; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Stewart F; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Artz A; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Curtin P; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Ball B; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • O'Hearn J; Department of Clinical Translational Project Development, City of Hope National Medical Center, Duarte, CA, USA.
  • Spielberger R; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Smith E; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Budde E; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Nakamura R; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Stein A; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Forman S; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Marcucci G; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Becker PS; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
  • Pullarkat V; Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA.
Leuk Lymphoma ; 64(11): 1811-1821, 2023.
Article in En | MEDLINE | ID: mdl-37533373
ABSTRACT
We conducted a retrospective analysis of WT1-mutated acute myeloid leukemia (AML) patients who underwent allogeneic stem cell transplant. Thirty-seven patients with WT1-mutated AML were identified. Primary induction failure (40%) and early relapse rate (18%) after idarubicin/cytarabine (7 + 3) chemotherapy were observed. All patients with induction failure subsequently achieved CR with additional chemotherapy. There was no significant difference between outcomes after myeloablative vs. reduced intensity (Fludarabine/Melphalan [Flu/Mel]) conditioning regimens. RFS but not OS was significantly better in patients who received FLAG-IDA prior to transplant and/or a fludarabine-containing conditioning. In an independent ex vivo study, WT1-mutated AML samples exhibited greater sensitivity to fludarabine (p = 0.026) and melphalan (p = 0.0005) than non-WT1-mutated AML samples while there was no difference between sensitivity to cytarabine. Our data favor using a fludarabine-based induction for AML with WT1 mutation instead of 7 + 3. Fludarabine conditioning regimens for alloHCT showed better RFS but not OS.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Leukemia, Myeloid, Acute / Melphalan Type of study: Diagnostic_studies Limits: Humans Language: En Journal: Leuk Lymphoma Journal subject: HEMATOLOGIA / NEOPLASIAS Year: 2023 Document type: Article Affiliation country: United States
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Leukemia, Myeloid, Acute / Melphalan Type of study: Diagnostic_studies Limits: Humans Language: En Journal: Leuk Lymphoma Journal subject: HEMATOLOGIA / NEOPLASIAS Year: 2023 Document type: Article Affiliation country: United States