| Title | High EVI1 Expression Predicts Poor Outcomes in Adult Acute Myeloid Leukemia Patients with Intermediate Cytogenetic Risk Receiving Chemotherapy |
| 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 |
| Affiliation | Peking Univ, Peoples Hosp, Inst Hematol, Beijing Key Lab Hematopoiet Stem Cell Transplanta, Beijing, Peoples R China. |
| Keywords | Gene Expression Leukemia, Myeloid, Acute Patient Outcome Assessment Real-Time Polymerase Chain Reaction INTERNAL TANDEM DUPLICATION ACUTE MYELOGENOUS LEUKEMIA MINIMAL RESIDUAL DISEASE DE-NOVO AML GENE-EXPRESSION PROGNOSTIC-SIGNIFICANCE HEALTHY DONORS BONE-MARROW MLL GENE GROUP-B |
| Issue Date | 2018 |
| Publisher | MEDICAL SCIENCE MONITOR |
| Citation | MEDICAL SCIENCE MONITOR. 2018, 24, 758-767. |
| Abstract | 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/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<0.0001). Multivariate analysis showed that EVI1 >= 1.0% was an independent adverse prognostic factor for RFS, DFS, and OS in the entire cohort. In addition, patients with EVI1 transcript levels between 1.0% and 8.0% had 2-year RFS rates similar to those with EVI1 >= 8.0%, and they both had significantly lower RFS rates than those with EVI1<1.0% (P= 0.0005 and 0.027). Conclusions: High EVI1 expression predicts poor outcome in ICR-AML patients receiving chemotherapy. The optimal cutoff value for patient stratification is different from the normal limit. |
| URI | http://hdl.handle.net/20.500.11897/510416 |
| ISSN | 1643-3750 |
| DOI | 10.12659/MSM.905903 |
| Indexed | SCI(E) PubMed |
| Appears in Collections: | 人民医院 |
