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Wilms tumor gene (WT1) expression as a panleukemic marker
Hans D Menssen1, Jan M Siehl, Eckhard Thiel
1Medical Clinic III, Hematology, Oncology, and Transfusion Medicine, University Clinic Benjamin Franklin, Free University, Berlin, Germany. hmenssen@zedat.fu-berlin.de
International Journal of Hematology
|September 7, 2002
Summary
Wilms tumor gene (WT1) is consistently found in acute leukemia blasts, unlike its limited expression in normal cells. New real-time quantitative methods offer promise for monitoring treatment response and detecting minimal residual disease in leukemia patients.
Area of Science:
- Hematology
- Molecular Biology
- Oncology
Background:
- Wilms tumor gene (WT1) is expressed in acute leukemia blasts, regardless of cell lineage.
- WT1 nuclear protein is detectable in most leukemic blasts, contrasting with its transient expression in few normal hematopoietic progenitors.
- While WT1 expression isn't specific to acute leukemia, its continuous presence in blasts is significant.
Purpose of the Study:
- To evaluate the clinical relevance of WT1 expression in acute leukemia.
- To address limitations of traditional WT1 detection methods in distinguishing between physiologic and pathologic expression.
- To explore the potential of real-time quantitative WT1 RT-PCR for monitoring treatment and detecting minimal residual disease.
Main Methods:
- Review of data on WT1 expression in leukemic blasts and normal hematopoietic progenitors.
- Discussion of limitations in quantitative and semiquantitative WT1 reverse transcriptase polymerase chain reaction (RT-PCR) protocols.
- Highlighting the development and testing of real-time quantitative WT1 RT-PCR protocols.
Main Results:
- WT1 is expressed in nearly all acute leukemia blasts, but only in a few normal hematopoietic progenitors.
- Traditional WT1 RT-PCR methods have limitations in discriminating between normal and cancerous WT1 expression levels.
- Real-time quantitative WT1 RT-PCR protocols show promise for clinical applications.
Conclusions:
- Continuous WT1 expression in leukemia blasts is a key differentiator from normal progenitors.
- Real-time quantitative WT1 RT-PCR offers a more reliable method for monitoring leukemia patients.
- This technique may aid in evaluating treatment response, detecting minimal residual disease, and differentiating certain leukemic conditions.