Expression of the p14ARF tumor suppressor predicts survival in acute myeloid leukemia

Leukemia. 2004 Apr;18(4):720-6. doi: 10.1038/sj.leu.2403296.

Abstract

Cell cycle aberrations are associated with therapy outcome in many types of cancer. We analyzed mRNA expression levels of 18 cell cycle-related genes in bone marrow samples from 78 acute myeloid leukemia (AML) patients and six controls using high-throughput quantitative RT-PCR. Samples of AML patients contained significantly increased mRNA expression levels of the mdm2 and c-myc oncogenes. Also, the average expression levels of p14ARF and p16INK4A were higher in patient samples compared to controls. Leukemic blasts and control bone marrow samples did not differ significantly in the expression levels of proliferation-associated genes such as cyclin A2 and pcna. When single genes were analyzed for prognostic significance in Kaplan-Meier and Cox regression analyses, a low p14ARF level emerged as a strong and independent predictor for poor survival (P=0.04 and 0.029). Subsequently, p14ARF mRNA levels were analyzed in a second, independent patient population (n=57). Again, low p14ARF levels were associated with a worse outcome. Finally, immunohistochemistry analysis of AML tissue arrays confirmed the widespread expression of c-myc and p14ARF in AML on the protein level. Taken together, the expression of the p53 regulators mdm2 and p14ARF are altered in AML, and low p14ARF levels indicate a poor prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Bone Marrow
  • Case-Control Studies
  • Cell Cycle / genetics
  • Cluster Analysis
  • Female
  • Gene Expression Profiling
  • Humans
  • Leukemia, Myeloid / diagnosis*
  • Leukemia, Myeloid / genetics
  • Leukemia, Myeloid / mortality
  • Male
  • Middle Aged
  • Nuclear Proteins*
  • Prognosis
  • Proto-Oncogene Proteins / analysis
  • Proto-Oncogene Proteins / genetics
  • Proto-Oncogene Proteins c-mdm2
  • RNA, Neoplasm / analysis*
  • Reverse Transcriptase Polymerase Chain Reaction
  • Survival Analysis
  • Tumor Suppressor Protein p14ARF / analysis*
  • Tumor Suppressor Protein p14ARF / genetics
  • Tumor Suppressor Protein p53 / metabolism

Substances

  • Nuclear Proteins
  • Proto-Oncogene Proteins
  • RNA, Neoplasm
  • Tumor Suppressor Protein p14ARF
  • Tumor Suppressor Protein p53
  • MDM2 protein, human
  • Proto-Oncogene Proteins c-mdm2