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Crucial role of BAALC-expressing leukemic precursors in origin and development of posttransplant relapses in patients with acute myeloid leukemias


Hematology & Transfusion International Journal
Nikolay N Mamaev, Alyena I Shakirova, Ildar M Barkhatov, Yana V Gudozhnikova, Tatiana L Gindina, Mikhail M Kanunnikov, Valentina M Kravtsova, Zhamal Z Rakhmanova, Olesya V Paina, Lyudmila S Zubarovskaya

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Abstract

The presented data are showing the crucial role and great prognostic significance of BAALCexpressing leukemic precursors in origin and development of posttransplant relapses (PTR) in acute myeloid leukemia patients with different cytological variants. For evidence simultaneous serial measurements of BAALC and WT1 transcript copy numbers by means of quantitative real time polymerase chain reaction were used at diagnosis, before conditioning regimen as well as at PTR in 50 patients treated with allogeneic hematopoietic stem cell transplantation (alloHSCT). Thirty-eight of them were adults and twelve pediatric patients aged 1-60 years (median – 25.8 years). It was shown, that BAALC gene overexpression to be presented in all studied cytological and being combined with increased level of WT1 expression at PTR in most of them. This combination was prognostically poor since it is largely associated with increased cumulative incidence of PTR (p<0.0001), and shortened event free (p<0.0001) and overall survival (p=0.002).

Keywords

acute myeloid leukemia, hematopoietic stem cell transplantation, posttransplant relapse, BAALC, WT1, combined overexpression

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