• Maki Baba, Tomoko Hata, Hideki Tsushima, Sayaka Mori, Daisuke Sasaki, Kazuto Turuta, Hiroo Hasegawa, Koji Ando, Yasushi Sawayama, Daisuke Imanishi, Jun Taguchi, Katsunori Yanagihara, Masao Tomonaga, Shimeru Kamihira, and Yasushi Miyazaki.
• Department of Hematology, Unit of Atomic Bomb Disease and Hibakusha Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan.
• Intern. Med. 2015 Jan 1; 54 (5): 445-51.

ObjectiveMyelodysplastic syndromes (MDS) are a group of hematological neoplasms associated with ineffective hematopoiesis and that transform to acute leukemia. Distinguishing MDS from other cytopenias is sometimes difficult even for trained hematologists. WT1, the gene mutated in Wilms' tumor, was found expressed in acute myeloid leukemia and MDS. The amount of WT1 in peripheral blood and bone marrow (BM) is low in low-risk MDS subtypes, and is high in high-risk MDS subtypes. However, the role of WT1 in the differential diagnosis between MDS and other diseases showing cytopenia has not been fully addressed. The present study evaluated whether WT1 expression level can assist in the differential diagnosis of MDS from other cytopenias.MethodsThe amount of WT1 message was evaluated among 56 MDS patients and 47 patients with cytopenia for various other reasons (cytopenia VR) at the Nagasaki University Hospital.ResultsThe level of WT1 was significantly related to the percentage of blasts in BM among MDS cases, and the type of French-American-British classification of MDS; refractory anemia (RA) cases showed significantly lower WT1 level than patients with RA with excess blasts. WT1 level was significantly related to the prognostic risk categories of MDS by the International Prognostic Scoring System (IPSS) and the revised IPSS. Although the blast percentage in the BM of RA and cytopenia VR were both less than 5%, there was a significant difference in the level of WT1 between MDS and cytopenia VR.ConclusionWT1 might be a good marker to differentiate low blast percentage MDS and cytopenia VR.

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