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Treatment of Molecular Relapse by Cessation of Immunosuppression After Hematopoietic Stem Cell Transplantation in Pediatric FLT3-ITD AML Monitored by WT1 Expression in Peripheral Blood

Løvvik Juul-Dam, Kristian MD, PhD*,†; Ifversen, Marianne MD, PhD; Guldborg Nyvold, Charlotte MSc, PhD†,§; Hansen, Maria MSc, PhD; Hasle, Henrik MD, PhD*

Journal of Pediatric Hematology/Oncology: November 30, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MPH.0000000000001365
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Relapse after hematopoietic stem cell transplantation in pediatric acute myeloid leukemia is a fatal event in the majority of cases. Immunotherapy may prevent an impending relapse if instituted at first molecular evidence of disease recurrence. Wilms tumor gene 1 (WT1) is overexpressed in the majority of children and may constitute a useful molecular marker of measurable residual disease applicable for disease monitoring in peripheral blood where the background amplification from healthy hematopoiesis is less prevalent compared with bone marrow. We report the measurable residual disease kinetics from a child with FLT3-internal tandem duplication acute myeloid leukemia where sequential WT1 monitoring in peripheral blood-guided withdrawal of immunosuppression.

*The Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital Skejby

Department of Hematology, Aarhus University Hospital, Aarhus, Denmark

Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen

§Department of Hematology, Odense University Hospital, Odense, Denmark

K.L.J.-D., C.G.N., and H.H.: Concept. M.H.: qPCR experiments. K.L.J.-D., M.I., C.G.N., M.H., and H.H.: Data collection, analyses and interpretation. K.L.J.-D.: Drafting of manuscript.

This study was supported by the Danish Childhood Cancer Foundation.

The authors declare no conflict of interest.

Reprints: Kristian Løvvik Juul-Dam, MD, PhD, The Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard, 8200 Aarhus N, Denmark (e-mail: krisju@rm.dk).

Received February 4, 2018

Accepted October 11, 2018

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