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Title: Follow-up of minimal residual disease in acute leukemia patients by monitoring of WT1 expression level by RQ-PCR


Wilms’ tumor gene (WT1) is involved in the pathogenesis of hematological disorders and solid tumors. High expression level of WT1 in the majority of leukemic cells as well as very low or undetectable levels in peripheral blood and bone marrow of healthy donors make this gene a very attractive marker of leukemic hematopoiesis. Aim: Assessment of the usefulness of WT1 expression measured by RQ-PCR as a marker of minimal residual disease (MRD) and as a prognostic factor in acute leukemia patients. Material and methods: A total of 50 patients treated in Hematology Clinic UJ CM diagnosed with acute leukemia were included in the study (32 with AML, 18 with ALL). Serial samples of peripheral blood were analyzed at presentation, after induction chemotherapy, consolidation course and during remission at 3-monthly intervals for 2 years. WT1 expression level was compared with disease course and fusion genes expression. In addition 50 blood samples obtained from healthy donors were tested. Results: WT1 expression level was measurable in 42 (82%) healthy donors. At presentation hyperexpression of the gene was found in 47 (94%) acute leukemia patients. Monitoring of MRD was performed in 36 patients (25 with AML, 11 with ALL), in 7 cases along with fusion genes monitoring. WT1 expression level in these patients correlated with the clinical course of acute leukemia and also with the presence of fusion transcripts in nested PCR. The mean time from increase of WT1 expression level to hematological relapse was 129 days (range 6-298). WT1 expression level higher than 20 WT1 copies /104 ABL copies after induction chemotherapy was associated with shorter overall survival (OS) and after consolidation course – with shorter OS and disease free survival (DFS). Cox regression analysis revealed that WT1 expression level after induction and consolidation chemotherapy were unfavourable prognostic factors influencing OS and DFS in patients with acute leukemia. Conclusion: WT1 expression is an useful marker for MRD monitoring in acute leukemia patients, especially in the absence of other molecular markers. High WT1 expression level after induction and consolidation chemotherapy is an important unfavourable prognostic factor.

Level of degree:

2 - studia doktoranckie

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Degree grantor:

Wydział Lekarski


Aleksander B. Skotnicki

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tylko w bibliotece

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Biblioteka Medyczna Uniwersytetu Jagiellońskiego - Collegium Medicum

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Last modified:

Feb 12, 2020

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Nov 21, 2012

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Edition name Date
ZB-107996 Feb 12, 2020


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