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High‐level MYC expression associates with poor survival in patients with acute myeloid leukemia and collaborates with overexpressed p53 in leukemic transformation in patients with myelodysplastic syndrome
Author(s) -
Gao Linlin,
Saeed Azhar,
Golem Shivani,
Zhang Da,
Woodroof Janet,
McGuirk Joseph,
Ganguly Siddhartha,
Abhyankar Sunil,
Lin Tara L.,
Cui Wei
Publication year - 2021
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/ijlh.13316
Subject(s) - myelodysplastic syndromes , medicine , myeloid leukemia , immunohistochemistry , myeloid , cancer research , leukemia , oncology , overall survival , bone marrow
Patients with mutated and overexpressed p53 have an aggressive course in acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Studies on the impact of MYC expression in AML are limited. This is the first study to evaluate MYC expression and p53 status in AML and MDS. Methods We identified 214 patients, 101 AML, 79 MDS, and 34 negative control patients. We retrospectively assessed p53 and MYC expression by immunohistochemistry and correlated MYC expression with p53 expression and aberrational status of TP53 . Results The level of both p53 and MYC expression was significantly higher in AML (mean: 9.7%; 12.1%) and MDS (mean: 5.2%; 5.5%) patients compared with control cases (mean: 0.18%; 2.3%; P = .001‐0.02). p53 and MYC expression levels were even more elevated in AML when compared to MDS patients ( P < .001). MYC expression was significantly associated with p53 expression and TP53 aberration in AML patients but not in MDS patients ( P < .001). p53 expression and >20% MYC expression showed an adverse impact on overall survival (OS) ( P < .05) in AML patients while p53 but not MYC expression showed an adverse impact on OS in MDS patients. MYC and p53 dual expression, as well as combined MYC expression and TP53 aberration, showed negative impact on OS in AML patients. MDS patients with leukemic transformation revealed an interval increase in expression of both p53 and MYC. Conclusion High‐level MYC expression associates with p53 abnormality and poor survival in AML. MYC may provide proliferative advantage for leukemic progression in p53 dependent and independent manner.