Prediction of outcome in acute myeloid leukemia by measurement of WT1 expression as a basic marker of minimal residual disease
10.3760/cma.j.issn.0253-2727.2017.08.009
- VernacularTitle: WT1基因在急性髓系白血病微小残留病监测中的应用
- Author:
Na ZHAO
1
;
Hui WEI
;
Ying WANG
;
Dong LIN
;
Chunlin ZHOU
;
Bingcheng LIU
;
Kaiqi LIU
;
Guangji ZHANG
;
Shuning WEI
;
Benfa GONG
;
Xiaoyuan GONG
;
Wei LI
;
Yan LI
;
Yuntao LIU
;
Shaowei QIU
;
Runxia GU
;
Yingchang MI
;
Jianxiang WANG
Author Information
1. Institute of Hematology & Blood Disease Hospital, CAMS & PUMC, Tianjin 300020, China
- Publication Type:Journal Article
- Keywords:
Wilms’tumor gene 1;
Leukemia, myeloid, acute;
Relapse
- From:
Chinese Journal of Hematology
2017;38(8):695-699
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To probe the potential utility of Wilms tumor 1 (WT1) as a marker of minimal residual disease (MRD) in acute myeloid leukemia (AML) to estimate the relapse-predicting cut-off value.
Methods:Quantitative assessment of bone marrow WT1 mRNA level was preformed using real-time quantitative reverse transcription polymerase chain reaction (RQ-RT-PCR) assay. The expression levels of WT1 dynamically measured with RQ-RT-PCR were retrospectively analyzed in 121 AML cases (not including acute promyelocytic leukemia) achieving complete remission (CR) after induction therapy followed by consolidation therapy. By comparing WT1 levels of patients with different post-therapy outcomes, the investigators used the receiver operating characteristic (ROC) curve to determine WT1 threshold so as to predict their clinical relapses. Then prognoses and the significance of intervention were analyzed between WT1 positive and negative patients according to the cut-off value of WT1.
Results:According to ROC curve, WT1 level higher than 2.98% predicted the possibility of relapse. For simplicity and clinical application, 3.00% was used as the cut-off value of WT1 level for relapse. WT1 levels in 41 patients at diagnosis were detected, meanwhile 3 patients whose WT1 levels at diagnosis below 3.00% were excluded, then the median WT1 level of the rest 38 patients at diagnosis was 44.09% (range 7.19%-188.06%) . The median WT1 level in remission was 0.48% (352 samples, range 0-8.41%) . The median WT1 level at diagnosis was higher than that in remission. Excluding the 3 patients with WT1 level at diagnosis under 3.00%, the relapse rate of WT1 positive group (>3.00% during consolidation phase and follow-up) and WT1 negative group (≤3.00%) was 70.0% (14/20) and 12.2% (12/98) respectively (P<0.001) . The median time from WT1 positivity to clinical relapse was 58 days.
Conclusions:WT1 expression level above 3.00% was associated with markedly high risk of relapse, which could be as a useful marker for monitoring MRD following consolidation therapy.
