BAALC and WT1 expressions from diagnosis to hematopoietic stem cell transplantation: consecutive monitoring in adult patients with core-binding-factor-positive AML.

No consecutive analysis of BAALC and WT1 expressions associated with core-binding factor AML ( CBF- AML) from diagnosis to hematopoietic stem cell transplantation ( HSCT) has yet been reported. We investigated BAALC and WT1 expressions using a method of real-time quantitative polymerase chain reaction ( RQ- PCR) at diagnosis, after induction chemotherapy, at pre- HSCT, and at post- HSCT period in 45 consecutive patients [t(8,21) ( n = 28), inv(16) (n = 17)], who received HSCT as a post-remission treatment. BAALC and WT1 RQ- PCR decrement ratio ( DR) was also calculated at post-induction chemotherapy, at pre- HSCT, and at post- HSCT compared with the diagnostic level. Higher BAALC expression at diagnosis showed significantly inferior OS ( P = 0.031), EFS ( P = 0.011), and higher CIR ( P = 0.002) rates. At post- HSCT, both higher BAALC and WT1 expressions showed significantly inferior OS ( P = 0.005, 0.016), EFS ( P = 0.002, 0.006), and higher CIR ( P = 0.001, 0.003) rates. A subgroup of t(8;21) showing higher BAALC and WT1 expressions at post- HSCT were also associated with inferior OS ( P = 0.018, 0.015) and higher CIR rates ( P = 0.019, 0.011). While BAALC DR showed no significant results on outcomes, WT1 DR more than 2-log at post- HSCT showed significantly lower CIR rate ( P = 0.028). This study showed that higher post- HSCT BAALC and WT1 expressions in patients with CBF- AML may be good markers of minimal residual disease for the prediction of survival and relapse after HSCT. [ABSTRACT FROM AUTHOR]