Prognostic Implications of Expression of the Wilms Tumor 1 (WT1) Gene in Acute Leukemia (Experience from South Egypt)

Background: Wilms’ tumor (WT1) gene expression has been reported in the majority of acute leukemia patients at diagnosis and has been evaluated as a prognostic and minimal residual disease (MRD) marker but its role is still controversial.
Methods: Real-time quantitative polymerase chain reaction was used on bone marrow samples from 100 newly diagnosed adults and pediatrics acute leukemia patients (50 AML and 50 ALL patients). WT1 expression were examined at diagnosis and at the end of induction.
Results: WT1 was expressed in (14%) ALL and in (36%) AML patients. We found no statistically significant impact of WT1 expression at diagnosis on response p= 0.054, 0.057, DFS (P = 0.591, 0.858), or OS (p= 0.339, p= 0.331) in ALL and AML patients respectively. Persistence of WT1 expressions at the end of induction didn't show any effect on relapse rate in AML however, it showed significant results in ALL p=0.045.
Conclusion: Our results suggest that WT1 expression in patients with acute leukemia doesn't have any implication on response or survival however, significant association was found in predicting ALL relapse but the small sample size should be considered.