| Objective:To examine the expression of the WT1 and CYP3A5 gene in different types of childhood acute leukemia and healthy controls , to study whether their expression may correlate with treatment and prognostic evaluation; to explore the relation between leukemia minimal residual disease and drug resistance mechanisms through analyze WT1 and CYP3A5, and provide original thinking for intervention study.Methods:Quantitative real-time RT-PCR was used to examine WT1 gene levels in the bone marrow of 198 cases. 119 cases are preliminary diagnosis patients,including 65 ALL and 32 AML patients; 69 cases are completely released, including 38 ALL and 31 AML patients; 10 cases are relapsed, including 4 ALL and 6 AML, normal controls contains 21 cases. Meanwhile to examine the CYP3A5 gene levels of 97 cases who can evaluate the curative effect and 10 relapsed cases, the results were analyzed according to the clinical data.Result:1,①The expression of WT1 gene levels in childhood acute leukemia is higher than normal controls(P<0.01), and AML group is higher than ALL group.②The expression of WT1mRNA was different in AML, M3 and M4 are obviously higher than M2 and M5.③WT1mRNA levels is different during different courses of disease, preliminary diagnosis and relapsed patients are highly expressed and its levels decrease when released.④The expression of WT1 in preliminary diagnosis patients has difference between complete remission group and non-remission group after one course of treatment during 97 cases who can evaluate clinical curative effect(P=0.004)。 ⑤WT1mRNA levels step up than before when relapsed through track detection of 3 cases during different courses of disease.2,①CYP3A5mRNA levels is different in preliminary diagnosis, relapsed group and normal controls, and it has obvious difference between relapsed group and normal controls(P=0.008).②CYP3A5 gene levels is the lowest in M3,and it has the statistics difference with M5(P=0.042).③When CYP3A5 gene and WT1 gene are both highly expressed , the remission rate is low.④When the patients are relapsed, the WT1 gene and CYP3A5 gene are both up grade .Conclusion:1,WT1 gene can monitor MRD as a leukemia marker, and to monitor its tendency can know the development of the disease.2,The CYP3A5 gene maybe participate in the drug fast mechanism in acute leukemia , it means bad for prognosis when both CYP3A5 and WT1 gene express highly at the same time. |
PDF Full Text Request