The Wilms' tumor gene-1 is a prognostic factor in myelodysplastic syndrome: a meta analysis

Previous studies have suggested that Wilms' tumor gene-1 (WT1) may be related to a decrease in both relapse-free survival (RFS) and overall survival (OS) for patients with myelodysplastic syndrome (MDS). Therefore, we conducted a meta-analysis on the utility of WT1 as a prognostic indicator of MDS. Published reports were searched in the following databases: Cochrane Library, PubMed, Embase, and Web of Science. The meta-analysis was conducted using the Cochrane Collaboration RevMan 5.2 software. Six publications with 450 total patients met the inclusion criteria and were subjected to further examination. The results showed a reduction in both overall survival (OS) and leukemia-free survival (LFS) with increasing WT1 expression levels: 1-year OS (odds ratio, OR = 0.16; 95% CI = 0.08-0.34, P < 0.001), 3-year OS (OR = 0.21; 95% CI = 0.09-0.47, P < 0.001), 5-year OS (OR = 0.24; 95% CI = 0.06-0.92, P = 0.04), 1-year LFS (OR = 0.06; 95% CI = 0.02-0.18; P < 0.001), 3-year LFS (OR = 0.20; 95% CI = 0.09-0.46; P < 0.001), and 5-year LFS (OR = 0.12; 95% CI = 0.04-0.38; P < 0.001). In terms of patients receiving hematopoietic stem cell transplantation, the cumulative incidence of relapse (CIR) was higher in the WT1 over-expression group than in the low-expression group: 1-year CIR (OR = 13.69; 95% CI = 2.99-62.62; P < 0.001), 3-year CIR (OR = 6.52; 95% CI = 2.31-18.40, P < 0.001). In conclusion, WT1 over-expression is a prognostic factor for MDS.