Abstract:

Objective To investigate the dynamic changes of WT-1 gene expression in patients with acute leukemia before and after chemotherapy and its role for evaluating therapeutic efficacy. Methods From June 2019 to June 2024，350 patients with acute leukemia at Baoding First Central Hospital were enrolled. They were classified into experimental group（175 cases，standard chemotherapy） and control group（175 cases，no chemotherapy or only palliative treatment）. Bone marrow samples were collected at specific time points before and after enrollment. The relative expression level of WT-1 gene was determined by real-time fluorescence quantitative polymerase chain reaction. Blood routine indicators （white blood cell count，hemoglobin，platelet count） and the proportion of bone marrow blasts were determined. The differences in various indicators between the 2 groups were compared. The clinical efficacy was evaluated according to the international standard. Results There was no statistical significance in WT-1 gene relative expression levels between the 2 groups before enrollment（P=0.132）. For 3，6 and 12 months after enrollment，the WT-1 gene relative expression level in experimental group was lower than that in control group（P<0.001）. In experimental group，the WT-1 gene relative expression level of patients with complete remission（CR） after chemotherapy was lower than those of patients with partial remission（PR） and non-remission（NR）（P<0.05）. The blood routine indicators of patients with CR after chemotherapy improved，while those of patients with PR and NR did not show significant improvement. The disease-free survival（DFS） of experimental group was longer than that of control group（P<0.05），and the survival rate of patients with low serum WT-1 gene relative expression was higher than that of patients with high expression（χ²=69.544，P<0.001）. Conclusions The relative expression level of WT-1 gene in patients with acute leukemia before and after treatment can be used as an indicator for evaluating therapeutic efficacy and prognosis. The decrease in WT-1 gene relative expression level in patients receiving standard chemotherapy is associated with prolonged DFS.

Key words: WT-1 gene, Acute leukemia, Standard chemotherapy, Disease-free survival