Prognostic significance of Wilms tumor 1 mRNA expression levels in peripheral blood and bone marrow in patients with myelodysplastic syndromes

BACKGROUND: This present study was designed to follow up 82 patients among 115 MDS patients registered in study ODK- 0801 for 5 years, to analyze the relationship between the WT1 mRNA expression level and prognosis. OBJECTIVE: This study aimed to investigate the clinical utility of WT1 mRNA expression levels. METHODS: After study ODK-0801, we investigated the conditions of the same patients once a year, including any clinical and laboratory findings supporting the diagnosis, and treatment among the living patients. RESULTS: When we assessed the survival time of 82 MDS patients by WT1 mRNA expression level, there were significant differences between the < 500 and ≥ 10⁴ copies/μg RNA groups and between the 500-10⁴ and ≥ 10⁴ copies/μg RNA groups for BM levels (p < 0.01). Examination of the time of freedom from acute myeloid leukemia (AML) transformation indicated that a high WT1 mRNA expression level (> 104 copies/μg RNA) was a strong prognostic factor for a short time to AML transformation. CONCLUSION: The results indicate that the tumorigenesis of MDS is likely to originate at the stem cell level, suggesting that the WT1 mRNA level measurement in the BM is an effective prognostic marker in patients with MDS.