Follow-up of minimal residual disease in acute childhood lymphoblastic leukemia by WT1 gene expression in the peripheral blood

The Hungarian experience

E. Magyarosy, N. Varga, J. Tímár, E. Rásó

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

The aim of the study was to investigate if monitoring WT1 gene expression in the peripheral blood is an appropriate approach to monitor the progression of childhood acute lymphoblastic leukemia (ALL). Forty-six patients have been enrolled into this study (24 ALL and 22 control, nonleukemic cases). The peripheral blood was tested for WT1 gene expression using a sensitive nested RT-PCR technique. The assay was sensitive enough to detect 102 leukemic cells among 106 normal leukocytes. In agreement with the literature 96% of childhood ALL (23/24) expressed WT1 independent of the prognostic factors of the disease. On the other hand, no WT1 gene expression was found in the peripheral blood of nonleukemic hematological diseases, except myelodysplasia. WT1 became negative in the peripheral blood of these patients at the end of the induction phase of the therapy in the majority of the cases (19/24), whereas clinical remission was achieved in all patients except one. WT1 gene expression changes in the peripheral blood was monthly monitored in 20 ALL patients for 1 year and in 16 cases during the second year (for a maximum of 21 months). Although continuous monitoring detected transient (1- to 3-month long) WT1 expression in the majority of the ALL cases (16/20), clinical relapse occurred in 2 cases only when the WT1 expression was maintained for 11-15 months. Follow up studies of the WT1 gene expression in the peripheral blood of WT1-positive childhood ALL may enable researchers to monitor MRD and detect a very low leukemic cell count (perhaps called "molecular relapse"). According to this study, the transient WT1 positivity for 1-3 months does not predict clinical relapse of childhood ALL, unlike a longer-lasting positivity.

Original languageEnglish
Pages (from-to)65-74
Number of pages10
JournalPediatric Hematology and Oncology
Volume20
Issue number1
Publication statusPublished - Jan 2003

Fingerprint

Residual Neoplasm
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Gene expression
Blood
Gene Expression
Recurrence
Monitoring
Hematologic Diseases
Gene Expression Profiling
Childhood
Assays
Leukocytes
Cell Count
Research Personnel
Polymerase Chain Reaction
Relapse

Keywords

  • Childhood acute lymphoblastic leukemia
  • Minimal residual disease
  • Wilms tumor-associated gene-1

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology
  • Cancer Research
  • Management of Technology and Innovation

Cite this

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title = "Follow-up of minimal residual disease in acute childhood lymphoblastic leukemia by WT1 gene expression in the peripheral blood: The Hungarian experience",
abstract = "The aim of the study was to investigate if monitoring WT1 gene expression in the peripheral blood is an appropriate approach to monitor the progression of childhood acute lymphoblastic leukemia (ALL). Forty-six patients have been enrolled into this study (24 ALL and 22 control, nonleukemic cases). The peripheral blood was tested for WT1 gene expression using a sensitive nested RT-PCR technique. The assay was sensitive enough to detect 102 leukemic cells among 106 normal leukocytes. In agreement with the literature 96{\%} of childhood ALL (23/24) expressed WT1 independent of the prognostic factors of the disease. On the other hand, no WT1 gene expression was found in the peripheral blood of nonleukemic hematological diseases, except myelodysplasia. WT1 became negative in the peripheral blood of these patients at the end of the induction phase of the therapy in the majority of the cases (19/24), whereas clinical remission was achieved in all patients except one. WT1 gene expression changes in the peripheral blood was monthly monitored in 20 ALL patients for 1 year and in 16 cases during the second year (for a maximum of 21 months). Although continuous monitoring detected transient (1- to 3-month long) WT1 expression in the majority of the ALL cases (16/20), clinical relapse occurred in 2 cases only when the WT1 expression was maintained for 11-15 months. Follow up studies of the WT1 gene expression in the peripheral blood of WT1-positive childhood ALL may enable researchers to monitor MRD and detect a very low leukemic cell count (perhaps called {"}molecular relapse{"}). According to this study, the transient WT1 positivity for 1-3 months does not predict clinical relapse of childhood ALL, unlike a longer-lasting positivity.",
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