Jan 6, 2007 Massachusetts scientists have identified a gene linked to the most common type of kidney cancer in children, and expressed hope this might help doctors determine which patients are most at risk of dying.

In a report issued on Friday in the journal Science, the team said about 30% of Wilms tumor cases involve mutations in a gene called WTX on the sex-determining X chromosome. About 90% of childhood kidney cancer cases are Wilms tumor, which occurs in one in 10,000 children worldwide.

The cancer is normally treated with surgery and chemotherapy, with about 80 per cent of patients surviving. The cancer usually appears by age five and the disease is also called nephroblastoma.

Dr Daniel Haber, a senior author of the study said: "The typical treatment for these children is you remove the kidney that's affected. If they have tumours in both kidneys, you take out one kidney and part of the other kidney and then you give chemotherapy,".

"Twenty per cent of these children will then have a recurrence of their tumour and die of their disease. So, clearly, if you could identify them up front, you would give more aggressive treatment," Dr Haber, the director of the Massachusetts General Hospital Cancer Centre in the US, said.

Treatment guide

Dr Haber says he hopes scientists can now determine whether the WTX gene can help predict the severity of a child's case of Wilms tumour to help guide treatment.

He added if doctors were able to determine a child had a less-threatening case, they could tailor less-intensive treatment.

"There's always an interest in paediatric cancers to try to lessen the amount of treatment if you could only identify markers of who has less-aggressive disease," Dr Haber said.

The kidneys filter the blood and rid the body of unneeded water, salt and waste in the form of urine.

Childhood kidney tumours originate in the early stem cells - those that will form the organ - of the kidney's filtering mechanism, the researchers say.

Scientists in 1990 identified mutations in another gene, called WT1, linked to Wilms tumour, but it is implicated in only about 5 per cent of cases.

Dr Haber's team looked at tumour samples from 82 patients to try to find further genetic abnormalities linked to the disease.

The WTX gene, they found, is in play in cells important to embryonic kidney development, indicating it may have a significant role in the organ's formation.

The discovery also indicates that X chromosome genes may have a bigger role in cancer than previously believed, they say.

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