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Overexpression of Wilms’ tumor ( WT1 ) is frequently observed in myelodysplastic syndrome (MDS), which has been proposed as a prognostic marker. However, the prognostic role of  WT1  expression in different contexts remains to be fully elucidated. We retrospectively assessed the relationships between  WT1  levels and preexisting prognostic factors to further investigate its prognostic role under different contexts. In our study,  WT1  expression was positively correlated with WHO 2016 classification and IPSS-R stratification. Lower  WT1  expression was found in relation to  TET2 ,  TP53 ,  CD101,  or  SRSF2  mutations, while mutant  NPM1  patients possessed higher level. Notably,  WT1  overexpression maintained its inferior prognostic effect on overall survival (OS) in  TP53 -wild patients but not in  TP53 -mutated group. In multivariate analysis, higher  WT1  expression was a risk factors for OS in EB patients without  TP53  mutations. Overall,  WT1  expression was useful to predict prognosis for MDS and its prognostic role was impacted by some gene mutations.

Wilms’ tumor 1 expression combined with genetic mutations for prognostic assessment in MDS