Wilms tumor (WT)1 gene expression in children with acute leukemia in Serbia
2016
Acute leukemias constitute the most common malignancy in childhood,
accounting for 25-35% of all cancer in children. They are divided into acute
lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Genetic
susceptibility is known to play a major role in childhood leukemias. Wilms
tumor (WT)1 is a zinc finger transcription factor involved in regulating the
process of cell differentiation; it has been implicated in a wide range of
human neoplasms. WT1 overexpression in the bone marrow at diagnosis is
reported to be an independent negative prognostic factor in adults and
children with AML. The aim of the present investigation was to determine the
expression of WT1 in the bone marrow of children with AML and ALL in Serbia
and its possible impact on patient survival. We determined bone marrow WT1
expression levels by reverse-transcription polymerase chain reaction (RT-PCR)
at diagnosis in 20 children with AML and 20 children with ALL (16 B-ALL and 4
T-ALL), as well as 15 age- and sex-matched controls who were evaluated for
immune thrombocytopenic purpura (ITP). For children with AML, follow-up
samples were also analyzed one month after treatment initiation and at
variable later timepoints of control punctures. The results were normalized
based on WT1 expression in controls. We found that children with AML had
significantly higher WT1 expression at diagnosis (median ± SD: 139.42 ±
244.03) than those with ALL (1.18 ± 54.37; Mann-Whitney U=82; p<0.01) and ITP
(0.76 ± 1.01; U=32; p<0.01). Patients with T-ALL had higher WT1 expression
than those with B-ALL, though significance was not reached due to subgroup
size; differences between AML subgroups according to the
French-American-British (FAB) classification were also below the level of
significance, though a tendency toward higher values in M3 and M4 leukemias
was notable. There was also a tendency toward higher values in 14 children
with AML who were still alive after a median follow-up of 1.5 years (181.42 ±
192.52) than in 6 who succumbed to the disease (104.29 ± 354.87). All
children with AML who had WT1 expression 1 month after diagnosis below the
fourth quartile (10 of 10) were still alive, while only 2 of 5 with 1-month
WT1 expression in the fourth quartile survived (Fisher’s exact test:
p=0.0952). Taken together, our results support a role for WT1 in the
diagnostic workup in children with acute leukemia, although it needs to be
considered in view of a complex and indvidualized context. [Projekat
Ministarstva nauke Republike Srbije, br. 41004]
Keywords:
- Correction
- Source
- Cite
- Save
- Machine Reading By IdeaReader
31
References
0
Citations
NaN
KQI