Prognostic Impact of WT-1 and Survivin Gene Expression in Acute Myeloid Leukemia Patients

Clin Lab. 2019 Apr 1;65(4). doi: 10.7754/Clin.Lab.2018.180329.

Abstract

Background: Wilms Tumor 1 (WT1) and Survivin genes are important leukemia-associated antigens (LAAs) in AML with potential prognostic impact.

Methods: We investigated WT1 and Survivin expression levels by RT-PCR in 61 AML patients in correlation with clinical characteristics and outcomes.

Results: WT1 was overexpressed in 45 patients (73.8%), associated with higher BM blasts (p = 0.017), lower incidence of favorable-prognosis cytogenetics (p = 0.035), and higher incidence of Flt3-ITD mutations (p = 0.026). Survivin was overexpressed in 17 patients (27.9%) with higher mean WBC count (p = 0.049). Patients with overexpression of either gene showed inferior complete remission (CR) rates and survival rates, patients with overexpression of both genes showed higher mean WBCs (p = 0.035) and higher BM blasts (p = 0.029) while the double negative group showed higher incidence of favorable cytogenetic events (p = 0.021), better CR rates and survival rates.

Conclusions: Our findings support the introduced prognostic impact of WT1 and Survivin genes in AML patients and its potential use in MRD monitoring and immunotherapy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers, Tumor / genetics
  • Cytogenetic Analysis
  • Female
  • Gene Expression Profiling
  • Gene Expression Regulation, Leukemic*
  • Humans
  • Immunotherapy
  • Leukemia, Myeloid, Acute / blood
  • Leukemia, Myeloid, Acute / diagnosis*
  • Leukemia, Myeloid, Acute / genetics*
  • Male
  • Middle Aged
  • Mutation
  • Prognosis
  • Remission Induction
  • Risk
  • Survivin / genetics*
  • Treatment Outcome
  • WT1 Proteins / genetics*
  • Young Adult
  • fms-Like Tyrosine Kinase 3 / genetics

Substances

  • BIRC5 protein, human
  • Biomarkers, Tumor
  • Survivin
  • WT1 Proteins
  • WT1 protein, human
  • FLT3 protein, human
  • fms-Like Tyrosine Kinase 3