Detection Of The Expression Of Wilms' Tumor Gene In Leukemia Patients By RT-PCR And Its Clinical Significance

[Objective] To evaluate the expression of WTl gene in leukemia patients and its clinical significance. [Method] Nest RT-PCR technique was used to examine the expression of the WTl gene in 50 patients with leukemias , 8 healthy volunteers and 3 patients with various hematopoietic non-malignancies. The regularity of the expression of WTl gene in leukemia patients was investigated and the relationship between WTl expression, the course of leukemia and the prognosis was explored. [Result] The sensitivity of detection of WTl mRNA by RT-PCR was 10-4. Seventeen out of 22 patients with ANLL (77.3%), six out of 11 patients with ALL (54. 5%) and one patient with AMLL showed evidence of WTl gene expression. Expression of WTl could be detected in all subset of FAB. Of 15 patients with CML, 8 patients in chronic phase didn' t express WT1 gene; but five out of 9 patients in blastic crisis (55.6%) expressed WTl gene; the expression was related to theprogression of clinical phase. One patient with PCL didn' t expressed WTl gene. All 8 healthy volunteers and 3 patients with various heraatopoietic non-malignancies also tested negative for WTl expression. The expression of WTl was related to the course of leukemia, and a relapse could be predicted earlier by detection of WTl than via clinic diagnoses. The rate of remission in the patients testing positive for WTl was lower than in those testing negative for WTl (31.3% vs 69.2%, P<0. 05).[Conclusion] Expression of WTl gene was revealed in all types of leukemia patients, regardless of the present or absence of tumor-specific DNA markers. Some regularities were found by continuous monitoring of the WTl gene, and indicated WTl could be a new prognostic factor and a panleukemia marker for the detection of MRD, and a marker for the phase progress of CML, used in the continuous monitoring of patients with leukemia.