Follow up study of Wilms’ tumor 1 (WT1) gene expression as a predictive marker for clinical outcome of acute myeloid leukemia in Iraqi population

Wilms' tumor gene 1 (WT1) is a universal tumor-associated antigen (TAA) expressed in a variety of malignancies. It is also quantitatively detectable and strongly expressed in the majority of acute leukemia patients. A recent study suggested that WT1 changes in gene expression levels might be utilized as a predictive marker to evaluate clinical outcomes at the time of diagnosis of (de novo) leukemia, followed by monitoring tumor development through treatment and follow-up. Methods: A total of twenty-nine (de novo) acute myeloid leukemia patients at presentation had 25 AML at the time of the first induction. The second induction had 17 AML patients, and 10 healthy volunteers, as a control group, were chosen for this study. The WT1 gene was assessed by Real-Time PCR with the Cyber Green assay. Results: AML patients had significantly higher levels of WT1 expression, compared to controls, who had low levels of WT1 expression. The WT1 gene overexpression was significantly associated with non-response AML patients compared to a complete response at diagnosis but showed no significant association after induction. Conclusion: The WT1 tumor antigen could be an early potential marker for acute leukemia prognosis. A lower expression of WT1 has been linked to improved clinical results. In contrast, a high level was associated with a bad prognosis in patients with AML, but further additional testing is needed.