論文

国際誌
2022年6月

Dynamic change in peripheral blood WT1 mRNA levels within three cycles of azacitidine predict treatment response in patients with high-risk myelodysplastic syndromes.

Annals of hematology
  • Shinpei Harada
  • Masahiro Onozawa
  • Daisuke Hidaka
  • Shota Yokoyama
  • Hajime Senjo
  • Shogo Takahashi
  • Reiki Ogasawara
  • Minoru Kanaya
  • Akio Mori
  • Shuichi Ota
  • Takeshi Kondo
  • Takanori Teshima
  • 全て表示

101
6
開始ページ
1239
終了ページ
1250
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s00277-022-04807-w

Azacitidine (AZA) improves overall survival (OS) in patients with high-risk myelodysplastic syndromes (MDS). However, predictive factors for response to AZA remain largely unknown. To elucidate whether dynamic change in peripheral blood (PB) Wilms' Tumor 1 (WT1) mRNA levels could predict response to AZA, we retrospectively identified 75 treatment-naïve patients with high-risk MDS who received at least 3 cycles of AZA. We classified patients into 4 groups, low-increase (LI), low-stable (LS), high-decrease (HD), and high-stable (HS) based on the dynamic change in PB WT1 mRNA levels within 3 cycles of AZA. Cumulative incidence of overall response after 10 cycles of AZA was significantly higher in LS/HD than in HS/LI (75.5% vs 4.5%, P < 0.001). The median OS for LS/HD was 18.2 months (95% CI, 12.8-28.1 months), whereas it was 11.6 months for HS/LI (95% CI, 6.6-14.1 months; P < 0.001). Multivariate analysis demonstrated that poor-/very poor-IPSS-R cytogenetic risk and HS/LI were independently associated with poor OS (poor-/very poor-IPSS-R cytogenetic risk: HR, 2.26; 95% CI, 1.10-4.68, P = 0.03, HS/LI: HR, 2.32; 95% CI, 1.21-4.46, P = 0.01). Patients with HS/LI did not show any further response to continuous AZA, and they should be considered for alternative therapy from earlier cycles.

リンク情報
DOI
https://doi.org/10.1007/s00277-022-04807-w
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/35257209
ID情報
  • DOI : 10.1007/s00277-022-04807-w
  • PubMed ID : 35257209

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