1. WT1-mutated acute myeloid leukemia is sensitive to fludarabine-based chemotherapy and conditioning regimens.
- Author
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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, and Nakamura, Ryotaro
- Subjects
ACUTE myeloid leukemia ,STEM cell transplantation ,CANCER chemotherapy ,FLUDARABINE - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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