title: Wilms Tumor 1 (WT1) mRNA Expression Level at Diagnosis Is a Significant Prognostic Marker in Elderly Patients with Myelodysplastic Syndrome.
abstract: OBJECTIVE
  A high expression of Wilms tumor 1 (WT1) mRNA occurs in most cases of acute leukemia and myelodysplastic syndrome (MDS). Although there are many reports suggesting that acute myeloid leukemia patients with high expression levels of WT1 mRNA have a relatively poor long-term survival, there are few reports addressing the relationship between WT1 levels and prognosis in MDS.
  
  
  METHODS
  We retrospectively analyzed 42 elderly patients with MDS whose WT1 levels at diagnosis were available, and we assessed the relationships between WT1 levels in peripheral blood and preexisting prognostic factors such as World Health Organization prognostic scores and Revised International Prognostic Scoring System risk categories, bone marrow blast percentages, and chromosomal abnormalities linked to a poor prognosis. We also evaluated the relationship between WT1 levels and prognosis.
  
  
  RESULTS
  WT1 levels were significantly different between high- and low-risk MDS patients (p < 0.05). There was a trend towards a significant difference between those with and those without poor prognostic chromosomal rearrangements (p = 0.051). Moreover, the overall survival and progression-free survival were significantly worse in elderly patients with higher levels of WT1 (p = 0.00039 and p = 0.00077, respectively).
  
  
  CONCLUSIONS
  The WT1 mRNA expression level at diagnosis may be a significant independent prognostic marker for elderly patients with MDS.
authors.affiliation: Department of Hematology, Seichokai Fuchu Hospital, Osaka, Japan.
authors.forename: Joji
authors.initials: J
authors.lastname: Nagasaki
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Aoyama
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hino
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ido
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Ichihara
authors.forename: Masahiro
authors.initials: M
authors.lastname: Manabe
authors.forename: Tadanobu
authors.initials: T
authors.lastname: Ohta
authors.forename: Atsuko
authors.initials: A
authors.lastname: Mugitani
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001374:Azacitidine / Q000627:therapeutic use; D015415:Biomarkers / Q000378:metabolism; D001854:Bone Marrow Cells / Q000378:metabolism* / Q000473:pathology; D002869:Chromosome Aberrations; D005260:Female; D015870:Gene Expression; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000235:genetics / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D012333:RNA, Messenger / Q000235:genetics* / Q000378:metabolism; D012107:Research Design; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D025721:WT1 Proteins / Q000235:genetics* / Q000378:metabolism
chemical_list: D000964:Antimetabolites, Antineoplastic; D015415:Biomarkers; D012333:RNA, Messenger; D025721:WT1 Proteins; C583751:WT1 protein, human; D001374:Azacitidine