{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T17:10:16Z","timestamp":1778778616962,"version":"3.51.4"},"reference-count":20,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"KROHEM\u2014The Foundation of the Croatian Cooperative Group for Hematological Diseases"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Relapse remains the leading cause of treatment failure after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in acute myeloid leukemia (AML). Early identification of patients at increased post-transplant relapse risk is essential to enable intensified surveillance and pre-emptive therapeutic strategies. Wilms\u2019 tumor 1 (WT1) is overexpressed in most AML cases and represents a broadly applicable molecular marker; however, its utility as a peripheral blood (PB) measurable residual disease (MRD) marker after allo-HSCT remains incompletely defined. In this prospective multicenter cohort study, 43 adults with AML in complete remission underwent allo-HSCT between 2021 and 2023. WT1 expression in PB was quantified using standardized real-time quantitative PCR before transplantation (WT1_pre) and at day +30 (WT1_30). Receiver operating characteristic analysis identified an optimal threshold for relapse prediction. A WT1 cutoff of \u22653 copies\/104\u00a0ABL discriminated relapse risk. WT1_30 demonstrated strong prognostic performance (AUC 0.79; p = 0.005), whereas WT1_pre showed more modest predictive value (AUC 0.69; p = 0.037). Patients with WT1_30 \u2265 3 had inferior 12-month progression-free survival compared with those with WT1_30 &lt; 3 (52.9% vs. 90.9%, p = 0.0059) and a higher 12-month cumulative incidence of relapse (31% vs. 9%, p = 0.054). WT1_pre \u2265 3 was also associated with inferior progression-free and overall survival (both p = 0.0008). Relapsed patients had significantly higher WT1_30 levels than non-relapsed patients (median 5.0 vs. 2.0 copies\/104 ABL; p = 0.018). Peripheral blood WT1 expression, particularly at day +30, is associated with an increased relapse risk after allo-HSCT in AML and may support early post-transplant risk stratification. The identified cutoff should be considered exploratory and requires validation in larger independent cohorts.<\/jats:p>","DOI":"10.3390\/ijms27104367","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T16:27:56Z","timestamp":1778776076000},"page":"4367","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Peripheral Blood WT1 Expression Predicts Relapse After Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia"],"prefix":"10.3390","volume":"27","author":[{"given":"Viktor","family":"Blaslov","sequence":"first","affiliation":[{"name":"University Hospital of Split, Spinciceva 1, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margareta","family":"Radic Antolic","sequence":"additional","affiliation":[{"name":"University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivana","family":"Horvat","sequence":"additional","affiliation":[{"name":"University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamara","family":"Vasilj","sequence":"additional","affiliation":[{"name":"Clinical Hospital Dubrava, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeljko","family":"Prka","sequence":"additional","affiliation":[{"name":"Clinical Hospital Dubrava, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonija","family":"Miljak","sequence":"additional","affiliation":[{"name":"University Hospital of Split, Spinciceva 1, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davor","family":"Galusic","sequence":"additional","affiliation":[{"name":"University Hospital of Split, Spinciceva 1, 21000 Split, Croatia"},{"name":"School of Medicine, University of Split, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucana","family":"Vicelic Cutura","sequence":"additional","affiliation":[{"name":"University Hospital of Split, Spinciceva 1, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marija","family":"Petric","sequence":"additional","affiliation":[{"name":"University Hospital of Split, Spinciceva 1, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8324-2176","authenticated-orcid":false,"given":"Alen","family":"Ostojic","sequence":"additional","affiliation":[{"name":"University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavle","family":"Roncevic","sequence":"additional","affiliation":[{"name":"University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iva","family":"Ivanko","sequence":"additional","affiliation":[{"name":"University Hospital Centre Sisters of Mercy Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Krecak","sequence":"additional","affiliation":[{"name":"General Hospital Sibenik, 22000 Sibenik, Croatia"},{"name":"School of Medicine, University of Rijeka, 51000 Rijeka, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goran","family":"Rincic","sequence":"additional","affiliation":[{"name":"University Hospital Centre Sisters of Mercy Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lana","family":"Desnica","sequence":"additional","affiliation":[{"name":"University Hospital Centre Zagreb, 10000 Zagreb, 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