1. The Wilms' tumor gene WT1 is a good marker for diagnosis of disease progression of myelodysplastic syndromes
- Author
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Tadamitsu Kishimoto, Manabu Kawakami, Hiroshi Iwama, Toyoshi Tatekawa, K. Fuchigami, Hiroyasu Ogawa, Jh H. Ohyashiki, Yusuke Oji, Yoshio Oka, Masao Tomonaga, Keisuke Toyama, Hiroya Tamaki, Kazuma Ohyashiki, Toshihiro Soma, Akio Tsuboi, Kazushi Inoue, Haruo Sugiyama, Katsuyuki Aozasa, and Eh H. Kim
- Subjects
Adult ,Male ,Cancer Research ,Genes, Wilms Tumor ,medicine.medical_treatment ,hemic and lymphatic diseases ,Biomarkers, Tumor ,Medicine ,Humans ,Tumor marker ,Aged ,DNA Primers ,Aged, 80 and over ,Chemotherapy ,Base Sequence ,business.industry ,Reverse Transcriptase Polymerase Chain Reaction ,Myelodysplastic syndromes ,Myeloid leukemia ,Wilms' tumor ,Hematology ,Middle Aged ,medicine.disease ,Minimal residual disease ,Transplantation ,medicine.anatomical_structure ,Oncology ,Myelodysplastic Syndromes ,Cancer research ,Disease Progression ,Female ,Bone marrow ,business - Abstract
The Wilms' tumor gene, WT1, is a tumor marker for leukemic blast cells. The WT1 expression levels were examined for 57 patients with myelodysplastic syndromes (MDS) (refractory anemia (RA), 35; RA with excess of blasts (RAEB) 14; RAEB in transformation (RAEB-t), six; and MDS with fibrosis, two) and 12 patients with acute myeloid leukemia (AML) evolved from MDS. These levels significantly increased in proportion to the disease progression of MDS from RA to overt AML via RAEB and RAEB-t in both bone marrow (BM) and peripheral blood (PB). WT1 expression levels in PB significantly correlated with the evolution of RAEB or RAEB-t to overt AML within 6 months. Therefore, WT1 expression levels in PB were superior to those in BM for early prediction of the evolution to AML by means of quantitation of the WT1 expression levels. Furthermore, WT1 expression in PB of patients with overt AML evolved from MDS was significantly decreased by effective chemotherapy or allogeneic stem cell transplantation and became undetectable in long-term survivors. These results clearly showed that WT1 expression levels are a tumor marker for preleukemic or leukemic blast cells of MDS and thus reflect the disease progression of MDS. Therefore, monitoring of WT1 expression levels has made continuous assessment of the disease progression of MDS possible, as well as the prediction of the evolution of RAEB or RAEB-t to overt AML within 6 months. The results also showed that quantitation of WT1 expression levels is useful for diagnosis of minimal residual disease of MDS with high sensitivity, thus making it possible to evaluate the efficacy of treatment for MDS.
- Published
- 1999