Prognostic impact of WT1 expression prior to hematopoietic stem cell transplantation in children with malignant hematological diseases
| Autor: | Susan Wittig, Caroline Woehlecke, Clemens Arndt, Bernd Gruhn |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Neoplasm Residual Adolescent medicine.medical_treatment Hematopoietic stem cell transplantation Real-Time Polymerase Chain Reaction Young Adult hemic and lymphatic diseases Internal medicine Biomarkers Tumor medicine Humans RNA Messenger Child WT1 Proteins Survival rate Hematology Reverse Transcriptase Polymerase Chain Reaction business.industry Hematopoietic Stem Cell Transplantation Infant Myeloid leukemia General Medicine Prognosis medicine.disease Hematologic Diseases Pediatric cancer Minimal residual disease Survival Rate Transplantation Leukemia Case-Control Studies Child Preschool Immunology Female Neoplasm Recurrence Local business Follow-Up Studies |
| Zdroj: | Journal of Cancer Research and Clinical Oncology. 141:523-529 |
| ISSN: | 1432-1335 0171-5216 |
| Popis: | Malignant hematological diseases represent the most common pediatric cancer. As they cannot always be cured by chemotherapy alone, leukemia and myelodysplastic syndrome (MDS) are frequent medical indications for hematopoietic stem cell transplantation, yet even this treatment is not capable of preventing relapse for certain. Therefore, molecular markers are used to monitor minimal residual disease (MRD) to be enabled to react early to an impeding relapse. As specific markers are not always available, Wilms’ tumor gene 1 (WT1) has been suggested as a universal marker, but has not yet been established clinically. We determined the level of WT1 gene expression in 130 children, adolescents and young adults with malignant hematological diseases prior to transplantation and evaluated its impact on patients’ outcome. A real-time quantitative RT-PCR was used for this purpose. The relationship between a high level of WT1 and the cumulative incidence of relapse, event-free survival and overall survival proved to be highly significant in univariate and multivariate analyses. Forty-eight percent of all patients with high WT1 levels suffered from a relapse, whereas only eight percent showing normal WT1 levels before transplantation relapsed. The most convincing result was found for acute myeloid leukemia (AML) and MDS. We conclude that WT1 expression prior to transplantation qualifies as an independent prognostic factor and should be further evaluated for MRD monitoring. It might especially be useful for patients with AML or MDS missing specific markers. |
| Databáze: | OpenAIRE |
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