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Prognostic significance of combined BAALC and MN1 gene expression level in acute myeloid leukemia with normal karyotype
Author(s) -
Marjanovic Irena,
KaranDjurasevic Teodora,
Kostic Tatjana,
Virijevic Marijana,
Vukovic Nada Suvajdzic,
Pavlovic Sonja,
Tosic Natasa
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.13405
Subject(s) - npm1 , myeloid leukemia , oncology , medicine , karyotype , leukemia , acute leukemia , biology , gene , genetics , chromosome
Acute myeloid leukemia with normal karyotype (AML‐NK) is the largest group of AML patients with very heterogeneous disease outcome. In order to ensure more precise risk stratification new molecular markers have been introduced, like expression level for BAALC (Brain and Acute Leukemia, Cytoplasmic) and MN1 (Meningioma 1) genes. Methods In this study, we investigated expression level of both genes in 111 adult AML‐NK at diagnosis and examined their prognostic potential. Results BAALC and MN1 expression were detected in about one third of the patients, and positive correlation between these two genes was found. The BAALC + /or MN1 + status was not associated with the presence of FLT3‐ITD mutations, but exhibited strong correlation with NPM1 wt status ( P < .001). Therefore, among BAALC + /or MN1 + patients the most frequent ones were FLT3‐ITD ‐ /NPM1 ‐ double negative patients with intermediate prognosis. When BAALC + /or MN1 + patients were divided into BAALC high /BAALC low (21/21) and MN1 high /MN1 low (21/22) groups, we detected that BAALC high /or MN1 high patients had a tendency toward lower complete remission rate. Also, survival analysis showed that BAALC high /or MN1 high patients had shorter disease‐free survival and overall survival (OS). The most pronounced influence on prognosis was detected in FLT3‐ITD ‐ /NPM1 ‐ group of patients that are lacking reliable prognostic markers, where OS in BAALC high /or MN1 high was only 5 months vs 25 months in BAALC low /or MN1 low . Conclusion These findings indicate that BAALC and MN1 expression level could be used for more precise risk stratification of AML‐NK patients and especially FLT3‐ITD ‐ /NPM1 ‐ patients, transforming this intermediate‐risk group, into a group with an adverse prognosis.