Prognostic value of renin gene expression in acute myeloid leukemia

• Published in: The Egyptian journal of haematology : the official journal of the Egyptian Society of Haematology 2018-04, Vol.43 (2), p.69-75
• Main Authors: Shalaby, Nahela, Eissa, Deena, Hassan, Naglaa, Azhary, Nevin, Saleh, Amany
• Format: Article
• Language: English
• Subjects: Acute myelocytic leukemia; Cancer genetics; Care and treatment; Chemotherapy; Diagnosis; Gene expression; Genetic aspects; Prognosis
• ISSN: 1110-1067; 2090-9268
• DOI: 10.4103/ejh.ejh_48_17

Background The majority of acute myeloid leukemia (AML) patients respond to initial chemotherapy, but only a minority of cases achieves long-term survival. Renin, as a part of the renin-angiotensin system, is directly linked to the activities of hematopoietic cytokines during normal hematopoiesis and in myeloproliferative neoplasms. In some hematological malignancies, blast cells have been observed to express renin, which is not found in normal marrow. Aim The aim of this was to study the expression of the renin gene as a prognostic marker in AML. Patients and methods Renin expression was measured in 45 AML patients and five controls by using quantitative real-time reverse-transcriptase PCR. Results Renin expression was detected in 93.3% of AML patients at diagnosis and 100% at relapse. Relapsed AML patients showed higher renin gene expression levels compared to those detected at complete remission and at diagnosis (P=0.000-0.001), respectively. None of our control subjects were positive for renin gene expression. At diagnosis, AML patients with haemoglobin less than 10 g/dl showed higher renin levels compared to those with haemoglobin of at least 10 g/dl. We used median renin gene expression levels to divide AML patients into high and low groups at diagnosis. At diagnosis, the group with higher renin expression showed higher total leukocyte count (TLC) than did the group with lower renin expression. At relapse, the higher renin expression group showed a higher peripheral blood (PB) blast percentage than did the lower renin expression group. Conclusion Renin expression can predict outcomes in AML patients and could be used as a therapeutic target.