Clinical Impact of Overexpression of FOXP3 and WT1 on Disease Outcome in Egyptian Acute Myeloid Leukemia Patients

  • Assem, Magda M (Department of Clinical Pathology, National Cancer Institute (NCI), Cairo university) ;
  • Osman, Ahmed (Department of Biochemistry, Faculty of Science, Ain Shams University) ;
  • Kandeel, Eman Z (Department of Clinical Pathology, National Cancer Institute (NCI), Cairo university) ;
  • Elshimy, Reham AA (Department of Clinical Pathology, National Cancer Institute (NCI), Cairo university) ;
  • Nassar, Hanan R (Medical Oncology, National Cancer Institute (NCI), Cairo university) ;
  • Ali, Radwa E (Department of Biochemistry, Faculty of Science, Ain Shams University)
  • Published : 2016.10.01


Background: In the last decade, it has become clear that change of gene expression may alter the hematopoietic cell quiescent state and consequently play a major role in leukemogenesis. WT1 is known to be a player in acute myeloid leukemia (AML) and FOXP3 has a crucial role in regulating the immune response. Objectives: To evaluate the impact of overexpression of WT1and FOXP3 genes on clinical course in adult and pediatric AML patients in Egypt. Patients and methods: Bone marrow and peripheral blood samples were obtained from 97 de novo non M3 AML patients (63 adult and 34 pediatric). Real-time quantitative PCR was used to detect overexpression WT1 and FOXP3 genes. Patient follow up ranged from 0.2 to 39.0 months with a median of 5 months. Results: In the pediatric group; WT1 was significantly expressed with a high total leukocyte count median 50X109/L (p=0.018). In the adult group, WT1 had an adverse impact on complete remission induction, disease-free survival and overall survival (p=0.02, p=0.035, p=0.019 respectively). FOXP3 overexpression was associated with FAB subtypes AML M0 +M1 vs. M2, M4+M5 (p =0.039) and the presence of hepatomegaly (p=0.005). Conclusions: WT1 and FOXP3 overexpression has an adverse impact on clinical presentation, treatment response and survival of pediatric and adult Egyptian AML patients.




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