High EVI1 Expression Predicts Poor Outcomes in Adult Acute Myeloid Leukemia Patients with Intermediate Cytogenetic Risk Receiving Chemotherapy

BACKGROUND Acute myeloid leukemia with intermediate cytogenetic risk (ICR-AML) needs to be stratified. The abnormal gene expression might be prognostic, and its cutoff value for patient grouping is pivotal. MATERIAL AND METHODS Ecotropic viral integration site 1 (EVI1) transcripts were assessed in 1...

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Published in:Medical science monitor 2018-02, Vol.24, p.758-767
Main Authors: Qin, Ya-Zhen, Zhao, Ting, Zhu, Hong-Hu, Wang, Jing, Jia, Jin-Song, Lai, Yue-Yun, Zhao, Xiao-Su, Shi, Hong-Xia, Liu, Yan-Rong, Jiang, Hao, Huang, Xiao-Jun, Jiang, Qian
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Antineoplastic Agents - therapeutic use
Bone Marrow - pathology
Clinical Research
Cohort Studies
Cytogenetics
Disease-Free Survival
Female
Gene Expression Regulation, Leukemic
Humans
Leukemia, Myeloid, Acute - diagnosis
Leukemia, Myeloid, Acute - drug therapy
Leukemia, Myeloid, Acute - genetics
Male
MDS1 and EVI1 Complex Locus Protein - genetics
MDS1 and EVI1 Complex Locus Protein - metabolism
Middle Aged
Nucleophosmin
Prognosis
Risk Factors
ROC Curve
Treatment Outcome
Young Adult
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Summary:BACKGROUND Acute myeloid leukemia with intermediate cytogenetic risk (ICR-AML) needs to be stratified. The abnormal gene expression might be prognostic, and its cutoff value for patient grouping is pivotal. MATERIAL AND METHODS Ecotropic viral integration site 1 (EVI1) transcripts were assessed in 191 adult ICR-AML patients at diagnosis who received chemotherapy only. MLL-PTD, WT1 transcript levels, FLT3-ITD, and NPM1 mutations were simultaneously evaluated, and 27 normal bone marrow samples were tested to define normal threshold. RESULTS The normal upper limit of EVI1 transcript levels was 8.0%. Receiver operating characteristic curve analysis showed that 1.0% (a 0.9-log reduction from the normal limit) was the EVI1 optimal cutoff value for significantly differentiating relapse (P=0.049). A total of 23 patients (12%) had EVI1 levels ≥1.0%. EVI1 ≥1.0% had no effect on CR achievement, whereas it was significantly associated with lower 2-year relapse-free survival (RFS), disease-free survival (DFS), and overall survival (OS) rates in the entire cohort (P=0.0003, 0.0017, and 0.0009, respectively), patients with normal karyotypes (P=0.0032, 0.0047, and 0.0007, respectively), and FLT3-ITD (-) patients (all P
ISSN:1643-3750
1234-1010
1643-3750
DOI:10.12659/MSM.905903