Prognostic significance of Wilms' tumor gene 1 expression in children with B-cell precursor acute lymphoblastic leukemia.

Autor:	Xue YJ; Department of Pediatrics, Peking University People's Hospital, Peking University, Beijing, China., Wang Y; Department of Pediatrics, Peking University People's Hospital, Peking University, Beijing, China., Zhang LP; Department of Pediatrics, Peking University People's Hospital, Peking University, Beijing, China., Lu AD; Department of Pediatrics, Peking University People's Hospital, Peking University, Beijing, China., Jia YP; Department of Pediatrics, Peking University People's Hospital, Peking University, Beijing, China., Zuo YX; Department of Pediatrics, Peking University People's Hospital, Peking University, Beijing, China., Zeng HM; Department of Pediatrics, Peking University People's Hospital, Peking University, Beijing, China.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2024 Jan 15; Vol. 13, pp. 1297870. Date of Electronic Publication: 2024 Jan 15 (Print Publication: 2023).
DOI:	10.3389/fonc.2023.1297870
Abstrakt:	Introduction: The prognostic role of Wilms' tumor 1 (WT1) gene expression at diagnosis in children with B cell precursor acute lymphoblastic leukemia (BCP-ALL) is still controversial. Methods: We detected the WT1 transcript levels of 533 de novo pediatric BCP-ALL patients using TaqMan-based real-time quantitative PCR and analyzed their clinical features. Results: The WT1 transcript levels differed among the distinct molecularly defined groups, with the highest levels in the KMT2A rearrangements ( KMT2A-r ) group. According to the results of the X-tile software, all patients were divided into two groups: WT1/ABL ≥ 0.24% (group A) and <0.24% (group B). The proportions of patients whose age was ≥10 years old, with immunophenotype of Pro-B, belonging in high-risk group, or with minimal residual disease (MRD) ≥ 0.01% at week 12 were significantly higher in group A than in group B. In the B-other group, WT1 overexpression was an independent risk factor of overall survival (OS) rate ( P = 0.042), and higher MRD ≥ 0.01% at week 12 was associated with lower OS rate ( P <0.001) and event-free survival rate ( P <0.001). Moreover, the subgroup analysis revealed that, in patients with initial WBC<50 × 10 9 /L or MRD<0.1% at day 33 or MRD<0.01% at week 12 or in the standard-risk group, WT1 overexpression led to a poorer outcome in comparison with those with WT1 downexpression ( P <0.05). Discussion: Therefore, pediatric BCP-ALL with WT1 overexpression had unique clinico-pathological characteristics and poor treatment response. In B-other patients, WT1 overexpression at diagnosis predicted an inferior prognosis. The WT1 gene may serve as a biomarker for monitoring residual disease in the B-other population, especially in children in the standard-risk group. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Xue, Wang, Zhang, Lu, Jia, Zuo and Zeng.)
Databáze:	MEDLINE
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