Prognostic Significance of WT1 Expression Level Thershold in Acute Myeloid Leukemia Patients Receiving Hematopoietic Stem Cell Transplantation: Meta-Analysis

Objective The WT1 gene is considered as a poor prognostic factor for acute myeloid leukemia (AML) after Allogeneic hematopoietic stem cell transplantation (Allo-HSCT). However, the effect of the expression threshold of WT1 on the prognosisis controversial, which is evaluated in this meta-analysis. Methods Relevant studies about the expression threshold of WT1 on the prognosis of AML after Allo-HSCT were searched in online databases. Data were extracted from them and analyzed by Stata16.0 software. Results Five studies involving 739 patients were screened out, including 433 cases experimental group and 306 cases control group. The experimental group and control group were compared for 1-year disease-free survival rate (DFS) [RR=1.19, 95%CI (1.03, 1.38), P =0.02] and 4-year DFS [RR= 1.18, 95%CI (0.98, 1.42), P =0.09]. The experimental group was lower than the control group in 1-year DFS, and there was no statistical significance in 4-year DFS. 1-year overall survival rate (OS) [RR=1.06, 95%CI (0.92, 1.23), P =0.40] and 4-year OS [RR= 1.16, 95%CI (1.03, 1.32), P =0.02], suggesting that the experimental group had a lower 4-year OS than the control group, and 1-year OS had no statistical significance. Conclusions High WT1 expression is unfavorable to the prognosis of AML patients undergoing Allo-HSCT. A threshold of 250 copies/104ABL of WT1 may be the best value for predicting the poor prognosis in these patients.