Clinical significance of real-time fluorescent quantitative PCR for detection of WT1 gene expression in leukemia patients

Objective To evaluate the relationship between the quantification of WT1 mRNA and prognosis in patients with leukemia.Methods WT1 mRNA level was detected with real time fluorescent quantitative PCR (RT-FQ-PCR) technique in bone marrow samples from 65 leukemia patients.Results The correlation coefficiency was over 0. 99 for standard curves of RT-FQ-PCR method. The median expression levels of WT1 in 43 newly diagnosed acute myeloid leukemia(AML) and 15 newly diagnosed acute lymphoblastic leukemia(ANLL) patient were significantly higher than those in normal control group(P=0.001). The WT1 expression level of chronic myeloid leukemia(CML) in blast crisis was higher than that of CML in chronic phase. The WT1 level was not correlated to peripheral WBC counts, hemoglobin and platelet counts. No significant differences of CR rate was found between the group with high WT1 expression levels and the group with low WT1 expression levels both in AML and ALL patients. The WT1 expression level was significantly reduced during complete remission. Long-term follow-up of WT1 expression level showed continuous or significant increase of WT1 expression in acute leukemia patients predicts refractoriness and impending relapse.Conclusion Quantification of WT1 expression level by RT-FQ-PCR may be used to predict relapse and monitor MRD for acute leukemia patients.