Sumiko Kobayashi1, Yasunori Ueda2, Yasuhito Nannya3, Hirohiko Shibayama4, Hideto Tamura5, Kiyoyuki Ogata5,6, Yoshiki Akatsuka7, Kensuke Usuki8, Yoshikazu Ito9, Masaya Okada10, Takahiro Suzuki11, Tomoko Hata11, Akira Matsuda12, Kaoru Tohyama13, Keiji Kakumoto14, Daisuke Koga15, Kinuko Mitani16, Tomoki Naoe17,18, Haruo Sugiyama19, Fumimaro Takaku20. 1. Department of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo, Japan. 2. Department of Haematology/Oncology, Transfusion and Haemapheresis Center, Kurashiki Central Hospital, Okayama, Japan. 3. Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 4. Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan. 5. Division of Hematology, Department of Medicine, Nippon Medical School, Tokyo, Japan. 6. Department of Hematology, Shin-Yurigaoka General Hospital, Kanagawa, Japan. 7. Department of Hematology, Fujita Health University School of Medicine, Aichi, Japan. 8. Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan. 9. Department of Hematology, Tokyo Medical University Hospital, Tokyo, Japan. 10. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan. 11. Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. 12. Department of Hemato-Oncology, Saitama International Medical Center, Saitama Medical University, Saitama, Japan. 13. Department of Laboratory Medicine, Kawasaki Medical School, Okayama, Japan. 14. Information Management Office, Drug Safety Research Center, Tokushima Research Institute, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan. 15. Diagnostic Division, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan. 16. Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Tochigi, Japan. 17. Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan. 18. National Hospital Organization Nagoya Medical Center, Nagoya, Japan. 19. Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, Osaka, Japan. 20. Japanese Association of Medical Sciences, Tokyo, Japan.
Abstract
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/μ g RNA groups and between the 500-104 and ≥ 104 copies/μ g RNA groups for BM levels (p < 0.01). Examination of the time of freedom from acute myeloid eukemia (AML) transformation indicated that a high WT1 mRNA expression level (> 104 copies/μ g 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.
BACKGROUND: This present study was designed to follow up 82 patients among 115 MDSpatients 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 MDSpatients by WT1 mRNA expression level, there were significant differences between the < 500 and ≥ 104 copies/μ g RNA groups and between the 500-104 and ≥ 104 copies/μ g RNA groups for BM levels (p < 0.01). Examination of the time of freedom from acute myeloid eukemia (AML) transformation indicated that a high WT1 mRNA expression level (> 104 copies/μ g 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.