IER3 (IEX-1) dysregulation serves as a potential prognostic factor in acute myeloid leukemia patients

Introduction: Immediate early response 3 (IER3) has association with hematological malignancies' risk and prognosis, such as myelodysplastic syndrome, while its relation to acute myeloid leukemia (AML) is not clear. This study aimed to explore the correlation of IER3 with AML risk, clinical characteristics, complete remission (CR), event-free survival (EFS), and overall survival (OS).

Methods: A total of 93 de novo AML patients were included in this study. In addition, 30 patients with non-hyperplasia hematologic malignancies requiring bone marrow testing (as disease controls) and 30 health donors (as health controls) were also recruited. Bone morrow samples of AML patients (before treatment), disease controls (before treatment), and health controls (at donation) were collected. IER3 in bone marrow mononuclear cells was detected by reverse transcription-quantitative polymerase chain reaction.

Results: IER3 was increased in AML patients compared with disease controls and health donors (both P < .001), and receiver operating characteristic (ROC) curve showed that IER3 had certain capability of distinguishing AML patients from disease controls (area under curve (AUC): 0.735, 95% confidence interval (CI): 0.650-0.820), and health donors (AUC: 0.789, 95% CI: 0.712-0.866). Meanwhile, IER3 was correlated with FLT3-ITD mutation (P = .030) and poor NCCN risk stratification (P = .031) in AML patients. Moreover, IER3 had negative association with CR in AML patients (P = .022), and showed certain potential in discriminating CR patients from non-CR patients (AUC: 0.655, 95% CI: 0.533-0.777). Besides, IER3 was negatively associated with EFS (P = .033), but not OS (P = .083) in AML patients.

Conclusion: IER3 dysregulation serves as a potential prognostic factor in AML patients.