Significant correlation between the degree of WT1 expression and the International Prognostic Scoring System Score in patients with myelodysplastic syndromes.
OBJECTIVE
To determine whether pattern of WT1 gene expression is a useful marker for establishing prognosis and tracking disease progression in patients with myelodysplastic syndromes (MDS).


METHODS
We performed a quantitative assessment of the WT1 transcript amount by real-time quantitative polymerase chain reaction (RQ-PCR) in 173 samples (131 bone marrow samples and 42 peripheral-blood samples) from 131 patients with MDS (79 patients with refractory anemia [RA], 31 with RA with excess blasts [RAEB], 18 with secondary acute myeloid leukemia [s-AML] evolved from MDS, and three with deletion of 5q as the sole cytogenetic abnormality). Values obtained were correlated with the blast percentage and International Prognostic Scoring System (IPSS) score.


RESULTS
Sixty-five percent of BM and 78% of PB samples for RA and 100% of BM and PB samples of RAEB and s-AML expressed WT1 transcript amounts greater than the level observed in healthy volunteers. The degree of WT1 expression was highly correlated with the type of MDS, was much higher in RAEB and s-AML compared with RA, and increased during disease progression. Moreover, a significant correlation was found between WT1 expression levels, blast cell percentage, and the presence of cytogenetic abnormalities. Therefore, we found a significant correlation between the amount of WT1 transcripts and the IPSS score, which currently represents the most reliable risk index of disease progression available for MDS patients.


CONCLUSIONS
WT1 is a useful molecular marker for risk assessment in MDS patients.
Division of Hematology and Internal Medicne, Department of Clinical and Biological Sciences, University of Turin, Italy.
Daniela
D
Cilloni
Enrico
E
Gottardi
Francesca
F
Messa
Milena
M
Fava
Patrizia
P
Scaravaglio
Marilena
M
Bertini
Mauro
M
Girotto
Carlo
C
Marinone
Dario
D
Ferrero
Andrea
A
Gallamini
Alessandro
A
Levis
Giuseppe
G
Saglio
D014408:Biomarkers, Tumor / Q000097:blood / Q000378:metabolism*; D001853:Bone Marrow / Q000378:metabolism; D016022:Case-Control Studies; D017931:DNA Primers; D018450:Disease Progression; D005434:Flow Cytometry; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D016130:Immunophenotyping; D007951:Leukemia, Myeloid / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D016133:Polymerase Chain Reaction; D011379:Prognosis; D012044:Regression Analysis; D025721:WT1 Proteins / Q000097:blood / Q000378:metabolism*
D014408:Biomarkers, Tumor; D017931:DNA Primers; D025721:WT1 Proteins