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Over expression of brain and acute leukemia, cytoplasmic and ETS‐related gene is associated with poor outcome in acute myeloid leukemia
Author(s) -
Hasan Syed Khizer,
Patkar Nikhil V.,
Rajamanickam Deepan,
Gokarn Anant,
LucenaAraujo Antonio R.,
Tembhare Prashant,
Bagal Bhausaheb,
Kadam Amare Pratibha,
Jain Hasmukh,
Gujral Sumeet,
Sengar Manju,
Subramanian Papagudi Ganesan,
Khattry Navin
Publication year - 2020
Publication title -
hematological oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 44
eISSN - 1099-1069
pISSN - 0278-0232
DOI - 10.1002/hon.2800
Subject(s) - erg , myeloid leukemia , hazard ratio , oncology , medicine , acute leukemia , proportional hazards model , leukemia , confidence interval , retinal , ophthalmology
The high expression of brain and acute leukemia, cytoplasmic ( BAALC ) and ETS‐related gene (ERG) has been reported to influence the outcome in acute myeloid leukemia (AML), but due to limited prospective studies, their role as prognostic factors is unclear. At diagnosis, the prognostic value of BAALC and ERG expression with respect to other cytogenetic and molecular markers was analyzed in 149 AML patients. Patients were divided into quartiles which resulted in the formation of four groups (G1–G4) based on expression values of BAALC and ERG and clinical response defined across groups. Groups with similar survival probabilities were merged together and categorized subsequently as high versus low expressers. Patients with high BAALC and ERG expression had significantly lower overall survival (OS; BAALC : p = 0.001 at 5 years 29.4% vs. 69.8%; ERG : p < 0.0001 at 5 years 4% vs. 50.4%) and disease‐free survival ( BAALC : p = 0.001 at 5 years 19.5% vs. 69.8%; ERG : p < 0.0001 at 5 years 4.2% vs. 47%). Patients were further stratified combining BAALC and ERG expression in an integrative prognostic risk score (IPRS). After a median follow‐up of 54 months (95% CI 45–63 months) among survivors, IPRS for high versus low expressers was a significant predictor for OS ( BAALC + ERG : 4% vs. 71.6%, p < 0.0001) and DFS ( BAALC + ERG : 4.5% vs. 74.1%, p < 0.0001). In a multivariate model, IPRS of BAALC + ERG expression retained prognostic significance for OS (hazard ratio [HR] 2.96, 95%CI 1.91–4.59, p < 0.001) and DFS (HR 3.61, 95%CI 2.26–5.76, p < 0.001).