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Published on: September 1, 2019
[Expression of WT1 gene in children with acute myeloid leukemia]
1Department of Pediatric Hematology and Oncology, West China Second University Hospital, Sichuan University; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China. gaoju651220@126.com.
Insights
WT1 gene expression in childhood acute myeloid leukemia (AML) correlates with prognosis. Monitoring WT1 levels aids in individualized treatment, prognosis assessment, and predicting relapse in pediatric AML patients.
Area of Science:
- Pediatric Oncology
- Molecular Diagnostics
- Hematologic Malignancies
Background:
- Acute myeloid leukemia (AML) in children requires accurate prognostic markers.
- Wilms Tumor 1 (WT1) gene expression is a potential biomarker in various cancers.
Purpose of the Study:
- To investigate WT1 gene expression in pediatric AML.
- To explore the correlation between WT1 expression and clinical outcomes in children with AML.
Main Methods:
- Real-time fluorescence quantitative PCR was used to assay WT1 gene expression.
- Bone marrow samples from 45 pediatric AML patients (excluding AML-M3) were analyzed.
- Retrospective analysis correlated WT1 levels with prognosis.
Main Results:
- Higher WT1 expression was associated with increased bone marrow blast percentage (>60%).
- Lower WT1 levels were observed in AML-M2 subtypes and complete remission.
- Higher WT1 expression at end of induction chemotherapy correlated with lower 2-year disease-free survival (DFS) and overall survival (OS).
- A ≥1 log WT1 reduction predicted significantly higher 2-year OS and DFS.
- WT1 levels tended to increase preceding bone marrow relapse.
Conclusions:
- WT1 gene expression is a significant prognostic indicator in pediatric AML.
- Dynamic monitoring of WT1 levels is crucial for personalized management and relapse prediction.
- WT1 serves as a valuable tool for prognosis evaluation in childhood AML.
Objective:
To study WT1 gene expression in children with acute myeloid leukemia (AML) and its possible correlations to clinical outcomes.
Methods:
Bone marrow samples were collected from 45 children with AML (excluding acute promyelocytic leukemia, AML-M3) at different time points of AML treatment and follow-up. WT1 gene expression levels in bone marrow mononuclear cells were assayed by real-time fluorescence quantitative PCR. The correlation between WT1 expression and prognosis was retrospectively analyzed.
Results:
The WT1 expression level in AML children with bone marrow blast cell percentage of >60% was significantly higher than in those with bone marrow blast cell percentage of ≤ 60% (p<0.05). The lower WT1 expression level was documented in children with AML-M2 compared with in children with other non-M2 subtypes (p<0.05). WT1 expression level in patients in complete remission was significantly lower than that in patients at diagnosis or relapse (p<0.01). The 2-year disease-free survival (DFS) in patients with higher WT1 expression was significantly lower than in those with lower WT1 expression at the end of induction chemotherapy (p<0.05). The 2-year overall survival (OS) and DFS in patients with ≥1 log WT1 reduction range were significantly higher than those with <1 log reduction of WT1 expression level at the end of induction chemotherapy (p<0.05). WT1 expression levels tended to rise 2-3 months prior to bone marrow relapse.
Conclusions:
WT1 expression level is closely correlated prognosis in children with AML. Dynamic monitoring of WT1 expression level is of great clinical importance in terms of individualized management, prognosis evaluation and relapse prediction.
