Adnan-Awad Shady, Meligui Yomna M El, Salem Salem Eid, Salaheldin Omina, Ayoub Mahmoud A, Kamel Mahmoud M
Clin Lab. 2019 Apr 1;65(4). doi: 10.7754/Clin.Lab.2018.180329.
Wilms Tumor 1 (WT1) and Survivin genes are important leukemia-associated antigens (LAAs) in AML with potential prognostic impact.
We investigated WT1 and Survivin expression levels by RT-PCR in 61 AML patients in correlation with clinical characteristics and outcomes.
WT1 was overexpressed in 45 patients (73.8%), associated with higher BM blasts (p = 0.017), lower incidence of favorable-prognosis cytogenetics (p = 0.035), and higher incidence of Flt3-ITD mutations (p = 0.026). Survivin was overexpressed in 17 patients (27.9%) with higher mean WBC count (p = 0.049). Patients with overexpression of either gene showed inferior complete remission (CR) rates and survival rates, patients with overexpression of both genes showed higher mean WBCs (p = 0.035) and higher BM blasts (p = 0.029) while the double negative group showed higher incidence of favorable cytogenetic events (p = 0.021), better CR rates and survival rates.
Our findings support the introduced prognostic impact of WT1 and Survivin genes in AML patients and its potential use in MRD monitoring and immunotherapy.
威尔姆斯瘤1（WT1）基因和生存素基因是急性髓系白血病（AML）中重要的白血病相关抗原（LAA），具有潜在的预后影响。
我们通过逆转录聚合酶链反应（RT-PCR）检测了61例AML患者的WT1和生存素表达水平，并将其与临床特征及预后相关联。
45例患者（73.8%）WT1基因过表达，与较高的骨髓原始细胞比例相关（p = 0.017），预后良好的细胞遗传学发生率较低（p = 0.035），Flt3内部串联重复（ITD）突变发生率较高（p = 0.026）。17例患者（27.9%）生存素过表达，其平均白细胞计数较高（p = 0.049）。任一基因过表达的患者完全缓解（CR）率和生存率较低，两个基因均过表达的患者平均白细胞数较高（p = 0.035）且骨髓原始细胞比例较高（p = 0.029），而双阴性组预后良好的细胞遗传学事件发生率较高（p = 0.021），CR率和生存率较好。
我们的研究结果支持WT1和生存素基因对AML患者预后的影响，以及其在微小残留病（MRD）监测和免疫治疗中的潜在应用。
