title: The level of bone marrow WT1 message is a useful marker to differentiate myelodysplastic syndromes with low blast percentage from cytopenia due to other reasons.
abstract: OBJECTIVE
  Myelodysplastic syndromes (MDS) are a group of hematological neoplasms associated with ineffective hematopoiesis and that transform to acute leukemia. Distinguishing MDS from other cytopenias is sometimes difficult even for trained hematologists. WT1, the gene mutated in Wilms' tumor, was found expressed in acute myeloid leukemia and MDS. The amount of WT1 in peripheral blood and bone marrow (BM) is low in low-risk MDS subtypes, and is high in high-risk MDS subtypes. However, the role of WT1 in the differential diagnosis between MDS and other diseases showing cytopenia has not been fully addressed. The present study evaluated whether WT1 expression level can assist in the differential diagnosis of MDS from other cytopenias.
  
  
  METHODS
  The amount of WT1 message was evaluated among 56 MDS patients and 47 patients with cytopenia for various other reasons (cytopenia VR) at the Nagasaki University Hospital.
  
  
  RESULTS
  The level of WT1 was significantly related to the percentage of blasts in BM among MDS cases, and the type of French-American-British classification of MDS; refractory anemia (RA) cases showed significantly lower WT1 level than patients with RA with excess blasts. WT1 level was significantly related to the prognostic risk categories of MDS by the International Prognostic Scoring System (IPSS) and the revised IPSS. Although the blast percentage in the BM of RA and cytopenia VR were both less than 5%, there was a significant difference in the level of WT1 between MDS and cytopenia VR.
  
  
  CONCLUSIONS
  WT1 might be a good marker to differentiate low blast percentage MDS and cytopenia VR.
authors.affiliation: Department of Hematology, Unit of Atomic Bomb Disease and Hibakusha Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Baba
authors.forename: Tomoko
authors.initials: T
authors.lastname: Hata
authors.forename: Hideki
authors.initials: H
authors.lastname: Tsushima
authors.forename: Sayaka
authors.initials: S
authors.lastname: Mori
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sasaki
authors.forename: Kazuto
authors.initials: K
authors.lastname: Turuta
authors.forename: Hiroo
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Koji
authors.initials: K
authors.lastname: Ando
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Sawayama
authors.forename: Daisuke
authors.initials: D
authors.lastname: Imanishi
authors.forename: Jun
authors.initials: J
authors.lastname: Taguchi
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yanagihara
authors.forename: Masao
authors.initials: M
authors.lastname: Tomonaga
authors.forename: Shimeru
authors.initials: S
authors.lastname: Kamihira
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyazaki
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D001853:Bone Marrow / Q000473:pathology*; D018076:DNA, Complementary; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007938:Leukemia / Q000145:classification / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis*; D032446:Myoblasts / Q000473:pathology*; D011379:Prognosis; D012333:RNA, Messenger; D025721:WT1 Proteins / Q000096:biosynthesis*
chemical_list: D015415:Biomarkers; D018076:DNA, Complementary; D012333:RNA, Messenger; D025721:WT1 Proteins; C583751:WT1 protein, human