Clinical Edge

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Use This to Evaluate MRD Prior to Allo-SCT

Leuk Res; 2017 Dec; Candoni, De Marchi, et al

Using Wilms' tumor expression to evaluate minimal residual disease prior to allogeneic stem cell transplantation (allo-SCT) can help predict post-transplant outcomes in patients with acute myeloid leukemia (AML) in cytologic complete remission, according to a study involving 122 individuals. Participants included patients with AML who were MRD-WT1 negative (n=81) or positive (n=41). Investigators looked at post-SCT overall survival, disease free survival, and relapse rate. Among the results:

  • Post-allo-SCT overall and disease-free survival rates were significantly better in patients who were MRD-WT1 negative at the time of SCT, vs those who were positive.
  • Both overall and disease-free survival were not reached in the negative group; in the positive group, they were 9 and 8 months, respectively.
  • Relapse rate post-SCT was 15% and 44%, respectively.
  • MRD-WT1 negativity pre-SCT and grade <2 acute graft-versus-host disease significantly predicted improved overall and disease-free survival, according to univariate analysis.
  • MRD-WT1 negativity pre-SCT was the only independent prognostic factor for improved overall and disease-free survival, according to multivariate analysis.


Candoni A, De Marchi F, Zannier, ME. High prognostic value of pre-allogeneic stem cell transplantation minimal residual disease detection by WT1 gene expression in AML transplanted in cytologic complete remission. Leuk Res. 2017;63:22-27. doi:10.1016/j.leukres.2017.10.010.