The Wilms’ tumor gene-1 is a prognostic factor in myelodysplastic syndrome: a meta analysis
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Yanan Jiang1,*, Lin Liu1,*, Jinhuan Wang2, Zeng Cao1 and Zhigang Zhao1
1Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
2Department of Oncology, Second Hospital of Tianjin Medical University, Institute of Urology, Tianjin 300060, China
*These authors are co-first authors
Zhigang Zhao, email: [email protected]
Keywords: myelodysplastic syndrome (MDS); wilms tumor-1 (WT1); prognostic factor; meta-analysis; survival
Received: April 07, 2017 Accepted: December 11, 2017 Epub: December 27, 2017 Published: March 23, 2018
Previous studies have suggested that Wilms’ tumor gene-1 (WT1) may be related to a decrease in both relapse-free survival (RFS) and overall survival (OS) for patients with myelodysplastic syndrome (MDS). Therefore, we conducted a meta-analysis on the utility of WT1 as a prognostic indicator of MDS. Published reports were searched in the following databases: Cochrane Library, PubMed, Embase, and Web of Science. The meta-analysis was conducted using the Cochrane Collaboration RevMan 5.2 software. Six publications with 450 total patients met the inclusion criteria and were subjected to further examination. The results showed a reduction in both overall survival (OS) and leukemia-free survival (LFS) with increasing WT1 expression levels: 1-year OS (odds ratio, OR = 0.16; 95% CI = 0.08–0.34, P < 0.001), 3-year OS (OR = 0.21; 95% CI = 0.09–0.47, P < 0.001), 5-year OS (OR = 0.24; 95% CI = 0.06–0.92, P = 0.04), 1-year LFS (OR = 0.06; 95% CI = 0.02–0.18; P < 0.001), 3-year LFS (OR = 0.20; 95% CI = 0.09–0.46; P < 0.001), and 5-year LFS (OR = 0.12; 95% CI = 0.04–0.38; P < 0.001). In terms of patients receiving hematopoietic stem cell transplantation, the cumulative incidence of relapse (CIR) was higher in the WT1 over-expression group than in the low-expression group: 1-year CIR (OR = 13.69; 95% CI = 2.99–62.62; P < 0.001), 3-year CIR (OR = 6.52; 95% CI = 2.31–18.40, P < 0.001). In conclusion, WT1 over-expression is a prognostic factor for MDS.
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