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WT-1 基因联合复发性细胞遗传学基因在急性髓系白血病中的预后价值。

Prognostic value of the WT-1 gene combined with recurrent cytogenetic genes in acute myeloid leukemia.

机构信息

Department of Hematology, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, Anhui, China.

出版信息

Immunogenetics. 2023 Aug;75(4):395-401. doi: 10.1007/s00251-023-01314-8. Epub 2023 Jun 22.

Abstract

Wilms tumor gene 1 (WT-1 gene) is overexpressed in most patients with acute myeloid leukemia (AML) and is an indicator for minimal residual disease (MRD) monitoring, but because the WT-1 gene has relatively low specificity, further studies of the prognostic value of a combination of the WT-1 and other genes are needed. The aim of this study was to explore the prognostic value of the WT-1 gene combined with recurrent cytogenetic genes in AML. In AML, the transcript expression of the WT-1 gene was closely related to leukemic tumor burden and acted as an accurate molecular indicator for MRD detection. Most patients with low expression levels of the WT-1 gene after induction and consolidation therapy were significantly associated with favorable relapse-free survival (RFS) and overall survival (OS), but 17.6% of patients relapsed and died of primary disease. However, when analyzing the WT-1 gene combined with recurrent cytogenetic genes, none of the patients with low expression levels of the WT-1 gene and recurrent cytogenetic genes negative relapsed and died in the median follow-up time of 19 months (range: 3-94 months). Thus, the combination of the WT-1 gene and recurrent cytogenetic genes is a more accurate indicator for MRD monitoring and prognosis evaluation in AML patients.

摘要

Wilms 肿瘤基因 1(WT-1 基因)在大多数急性髓系白血病(AML)患者中过度表达,是微小残留病(MRD)监测的指标,但由于 WT-1 基因特异性相对较低,需要进一步研究 WT-1 基因与其他基因组合的预后价值。本研究旨在探讨 WT-1 基因与 AML 中反复出现的细胞遗传学基因的组合的预后价值。在 AML 中,WT-1 基因的转录表达与白血病肿瘤负荷密切相关,是 MRD 检测的准确分子指标。诱导和巩固治疗后 WT-1 基因低表达水平的大多数患者与良好的无复发生存(RFS)和总生存(OS)显著相关,但 17.6%的患者复发并死于原发性疾病。然而,当分析 WT-1 基因与反复出现的细胞遗传学基因结合时,在中位随访时间为 19 个月(范围:3-94 个月)时,没有 WT-1 基因和反复出现的细胞遗传学基因低表达水平的患者复发和死于疾病。因此,WT-1 基因与反复出现的细胞遗传学基因的结合是 AML 患者 MRD 监测和预后评估的更准确指标。

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