Molecular stratification model for prognosis in cytogenetically normal acute myeloid leukemia

Blood. 2009 Jul 2;114(1):148-52. doi: 10.1182/blood-2008-11-187724. Epub 2009 Apr 27.

Abstract

We have evaluated 9 new molecular markers (ERG, EVI1, MLL-PTD, MN1, PRAME, RHAMM, and WT1 gene-expression levels plus FLT3 and NPM1 mutations) in 121 de novo cytogenetically normal acute myeloblastic leukemias. In the multivariate analysis, high ERG or EVI1 and low PRAME expressions were associated with a shorter relapse-free survival (RFS) and overall survival (OS). A 0 to 3 score was given by assigning a value of 0 to favorable parameters (low ERG, low EVI1, and high PRAME) and 1 to adverse parameters. This model distinguished 4 subsets of patients with different OS (2-year OS of 79%, 65%, 46%, and 27%; P = .001) and RFS (2-year RFS of 92%, 65%, 49%, and 43%; P = .005). Furthermore, this score identified patients with different OS (P = .001) and RFS (P = .013), even within the FLT3/NPM1 intermediate-risk/high-risk subgroups. Here we propose a new molecular score for cytogenetically normal acute myeloblastic leukemias, which could improve patient risk-stratification.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antigens, Neoplasm / genetics
  • Biomarkers, Tumor / genetics*
  • Cytogenetic Analysis
  • DNA-Binding Proteins / genetics
  • Disease-Free Survival
  • Female
  • Gene Expression
  • Genetic Markers
  • Humans
  • Leukemia, Myeloid, Acute / genetics*
  • Leukemia, Myeloid, Acute / mortality
  • MDS1 and EVI1 Complex Locus Protein
  • Male
  • Middle Aged
  • Models, Genetic*
  • Mutation
  • Nucleophosmin
  • Prognosis
  • Proto-Oncogenes / genetics
  • Risk Factors
  • Spain / epidemiology
  • Survival Rate
  • Trans-Activators / genetics
  • Transcription Factors / genetics
  • Transcriptional Regulator ERG

Substances

  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • DNA-Binding Proteins
  • ERG protein, human
  • Genetic Markers
  • MDS1 and EVI1 Complex Locus Protein
  • MECOM protein, human
  • NPM1 protein, human
  • PRAME protein, human
  • Trans-Activators
  • Transcription Factors
  • Transcriptional Regulator ERG
  • Nucleophosmin