The Prognostic Value Of WT1Expression For Acute Myeloid Leukemia

ObjectivesTo investigate the prognostic value of Wilms’ Tumor gene (WT1) expressionlevel in bone marrow for acute myeloid leukemia (AML) patients.Methods①A real time quantitative reverse transcription-polymerase chain reaction(RQ-RT-PCR) method was established for detecting WT1expression levels in bonemarrow of122newly diagnosed AML patients and21non-AML controls.②122newly diagnosed AML patients were divided into two groups: the highWT1expression group and the low WT1expression group, which were thencompared from different parameters including the complete remission after the firstinduction chemotherapy (CR1), two-year leukemia-free survival (LFS) and two-yearoverall survival (OS).Results1. The median expression level of WT1in122newly diagnosed AML patientswas0.677(0～1.673), and that in21non-AML controls was0.007(0～0.019), thedifference between AML patients and the controls is significant(P<0.05). In122newly diagnosed AML patients, the AML-M3group has the highest median WT1expression level, that is0.853(0.335～1.673), P <0.05. the AML-M1group has thelowest median WT1expression level, that is0.329(0.358～1.432), P>0.05. There areno difference among others AML subgroup in the WT1expression level.2. For32AML-M3patients, the median expression level of WT1was0.853 （0.335～1.673). Except for4patients who died from intracerebral hemorrhage andsevere infection in the first Induction chemotherapy, the other28AML-M3patientsdid not suffer from any hematological recurrence and death. So statistical analysisindicated no significant difference between CR1, two-year LFS, two-year OS and theWT1expression level (P>0.05).With regard to non-M3AML patients, CR1in the high and low expressiongroups were52.3%and82.6%; two-year LFS were33.3%and53.7%; two-year OSwere36.0%and57.7%, respectively. There were statistically significant differencesabout the life curve (P<0.05).Conclusions:1. WT1gene mRNA expression in acute myeloid leukemia was higher than innormal donors or non-leukemia patient, so WT1gene expression level is a goodmaker for the diagnosis of acute myeloid leukemia.2. Low WT1expression level had more favorable prognosis than the highexpression level. Thus, WT1expression level could be an useful prognosis marker forassessing AML patients.