Assem Magda, Osman Ahmed, Kandeel Eman, Elshimy Reham, Nassar Hanan, Ali Radwa
Department of Clinical Pathology, National Cancer Institute (NCI), Cairo university, Cairo, Egypt. Email:
Asian Pac J Cancer Prev. 2016 Oct 1;17(10):4699-4711. doi: 10.22034/apjcp.2016.17.10.4699.
Background: In the last decade, it has become clear that change of gene expression may alter the hematopoietic cell quiescent state and consequently play a major role in leukemogenesis. WT1 is known to be a player in acute myeloid leukemia (AML) and FOXP3 has a crucial role in regulating the immune response. Objectives: To evaluate the impact of overexpression of WT1and FOXP3 genes on clinical course in adult and pediatric AML patients in Egypt. Patients and methods: Bone marrow and peripheral blood samples were obtained from 97 de novo non M3 AML patients (63 adult and 34 pediatric). Real-time quantitative PCR was used to detect overexpression WT1 and FOXP3 genes. Patient follow up ranged from 0.2 to 39.0 months with a median of 5 months. Results: In the pediatric group; WT1 was significantly expressed with a high total leukocyte count median 50X109/L (p=0.018). In the adult group, WT1 had an adverse impact on complete remission induction, disease-free survival and overall survival (p=0.02, p=0.035, p=0.019 respectively). FOXP3 overexpression was associated with FAB subtypes AML M0 +M1 vs. M2, M4+M5 (p =0.039) and the presence of hepatomegaly (p=0.005). Conclusions: WT1 and FOXP3 overexpression has an adverse impact on clinical presentation, treatment response and survival of pediatric and adult Egyptian AML patients.
在过去十年中，基因表达的改变可能会改变造血细胞的静止状态，并因此在白血病发生过程中发挥重要作用，这一点已变得清晰。已知WT1在急性髓系白血病（AML）中发挥作用，而FOXP3在调节免疫反应中起关键作用。目的：评估WT1和FOXP3基因过表达对埃及成人和儿童AML患者临床病程的影响。患者与方法：从97例初发非M3 AML患者（63例成人和34例儿童）中获取骨髓和外周血样本。采用实时定量PCR检测WT1和FOXP3基因的过表达情况。患者随访时间为0.2至39.0个月，中位时间为5个月。结果：在儿童组中，WT1表达显著，总白细胞计数中位数较高，为50×10⁹/L（p = 0.018）。在成人组中，WT1对完全缓解诱导、无病生存和总生存有不利影响（分别为p = 0.02、p = 0.035、p = 0.019）。FOXP3过表达与FAB亚型AML M0 + M1与M2、M4 + M5相关（p = 0.039）以及肝肿大的存在相关（p = 0.005）。结论：WT1和FOXP3过表达对埃及儿童和成人AML患者的临床表现、治疗反应和生存有不利影响。
