[Clinical course of the disease and the level of WT1 mRNA in 191 patients with acute myeloid leukemia (AML): joint research by 23 institutions in Japan].
We evaluated the clinical course of acute myeloid leukemia (AML) and the levels of WT1 mRNA in 191 AML patients. Of 114 previously untreated patients with AML, 107 cases were positive for WT1 mRNA (93.9% : 107/114). WT1 mRNA expression-levels declined to below 50 copies/microg RNA ("negative") after remission was achieved in all 66 patients who achieved remission and 84.8% (47/54) cases were "negative" at the end of the follow-up periods. On the other hand, WT1 mRNA was expressed in 87.0% of non-remission cases (47/54), maintaining 50 copies/microg of RNA or higher ("positive"). In all 29 cases who relapsed during the follow-up observation period after achieving remission, WT1 mRNA levels declined transiently approximately around the time of achieving remission and then rose again when the disease relapsed. Moreover, we determined the time of elevation of WT1 mRNA in 29 relapsed cases. In 79.3% of relapsed cases (23/29), WT1 mRNA levels rose above 200 copies/microg RNA, 43 days (median) before the diagnosis of "relapse". Given the percent of the correct diagnosis, WT1 mRNA at 200 copies/microg RNA appeared to be a reasonable cut-off level for early detection of AML-relapse. The WT1 mRNA level reflected the clinical condition. Taken together, these findings indicate that WT1 mRNA levels allow us to detect the presence of so-called "minimal residual disease" (leukemic cells) that cannot be detected by morphological examination. Besides these promising data, this kit is suitable for routine monitoring of AML because this kit utilizes peripheral blood as a test specimen, reducing the patient's burden at the time of collection of clinical samples as compared with bone marrow aspirate.
Miyawaki
Shuichi
S
Saiseikai Maebashi Hospital (Division of Hematology).
Emi
Nobuhiko
N
Mitani
Kinuko
K
Oyashiki
Kazuma
K
Kitamura
Kuniaki
K
Morishita
Takehisa
T
Ogawa
Hiroyasu
H
Komatsu
Norio
N
Soma
Toshihiro
T
Tamaki
Toshiharu
T
Kosugi
Hirofumi
H
Ohnishi
Kazunori
K
Mizoguchi
Hideaki
H
Hiraoka
Akira
A
Kodera
Yoshinao
Y
Ueda
Ryuzo
R
Morishima
Yasuo
Y
Nakagawa
Masashi
M
Tobita
Tadashi
T
Sugimoto
Koichi
K
Chiba
Shigeru
S
Inoue
Nobumasa
N
Hamaguchi
Motohiro
M
Koga
Daisuke
D
Tamaki
Hiroya
H
Naoe
Tomoki
T
Sugiyama
Haruo
H
Takaku
Fumimaro
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007564:Japan; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D018365:Neoplasm, Residual / Q000175:diagnosis; D016133:Polymerase Chain Reaction / Q000379:methods; D012333:RNA, Messenger / Q000097:blood*; D012334:RNA, Neoplasm / Q000097:blood*; D011933:Reagent Kits, Diagnostic; D025721:WT1 Proteins / Q000235:genetics*
D014408:Biomarkers, Tumor; D012333:RNA, Messenger; D012334:RNA, Neoplasm; D011933:Reagent Kits, Diagnostic; D025721:WT1 Proteins