Analysis Of Eiffcacy And Prognosis On Acute Leukemia (AL) With High WT1Expression Levels Or Acute Myeloid Leukemia (AML) With T (8;21)

Objective: To evaluate the expression of WT1mRNA in acute leukemia (AL)patients and its clinical significance and study the clinical and biologicalcharacteristics and multiple factors therapeutic effect and prognosis of acute myeloidleukemia (AML) with t (8;21) translocation.Method: Real time quantitative reverse transcriptase polymerase chain reaction(RQ-PCR) method was used to detect the expression level of WT1mRNA in bonemarrow mononuclear cells (BMMNS) of55patients with newly diagnosed AL and toinvestgate the clinical significance of the expression of WT1mRNA in diagnosingand monitoring of minimal residual disease (MRD) and its efficacy and prognosticvalue by conducting dynamic monitoring of the expression levels of WT1mRNA. Aretrospective analysis including cell morphology, chromosome, immunophenotype,molecular biology and clinical curative effect was performed on54cases of t (8;21)AML. The control group included83cases of AML with normal karyotype during thesame period.Results: The expression level of WT1mRNA in newly diagnosed AL patients was101.3, which was higher than complete remission (CR) group and control group (1.98and2.91respectively). The expression levels of WT1decreasing continually ofensuggested the diseases were in CR condition.Instead, the expression levels keepinghigh or rising agin ofen suggested the diseases were difficult to achieve CR or wererecurrence.No significant differences of CR rate and relapse rates was found betweenthe group with high WT1exprssione levels and the group with low WT1expressionlevels, but the survival rate of high WT1expression group was lower than low group.In54AML patients with t (8;21), M2was accounted for59.2%according to the FABclassification. In bone marrow of newly diagnosed patients, the rate of blastocytes was47.92±21.63%, the positive rate of CD34, CD33,CD7, CD117and CD19was76.1%,56.2%,3.8%,78.3%and67.9%respectively. Additional chromosomalabnormalities was accounted for44.4%.The CR rate, relapse rate and average CRduration was75.7%,55.6%and225days respectively.Conclusions:1. The expression level of WT1mRNA was high in AL patients.2.Thepatients with high expression levels of WT1at diagnosis often had low survival rates,but the high levels of WT1was not independent factor of clinical outcome.3.Conducting dynamic monitoring of the expression levels of WT1mRNA could beused to evaluate efficacy, assess prognostic and detect MRD.4.Compared with thenormal karyotype AML patients, t(8;21) AML patients had lower percentages ofbone marrow blastocytes and peripheral WBC (P<0.05),and had higher expression ofCD34、CD19、CD117（P<0.05）,lower expression of CD33、CD7（P<0.05）.5.Therewere no difference of CR rate, relapse rate and average CR duration between twogroups. In t (8;21) AML patients, high expression of CD19could not affect CR rate,co-expression of CD7and CD19, secondary AML or other genetic abnormality werepoor prognosis factors.6. Most factors could affect the efficacy and prognosis of t (8;21) AML. As a result, t (8;21) is not the only index for efficacy and prognosis ofAML.