Article

Prognostic Implication of BAALC Gene Expression in Adult Acute Myeloid Leukemia

Children Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Clinical laboratory (Impact Factor: 1.08). 01/2013; 59(5-6):621-8. DOI: 10.7754/Clin.Lab.2012.120604
Source: PubMed

ABSTRACT Recently various molecular markers and global gene expression profiling have been investigated to improve risk profile characterization of AML with normal cytogenetics. Our main objective is to investigate the prognostic impact of brain and acute leukemia, cytoplasmic (BAALC) expression in AML with normal karyotype.
BAALC expression was analysed using quantitative real time (QRT) PCR.
High expression was detected in 22 of 45 patients (48.9%) and its expression did not correlate with the clinical parameters of patients. High BAALC expressers had significantly lower incidence of CR (22.7% vs. 73.9%; p = 0.001), higher mortality rate (72.1% vs. 39.1%; p = 0.023), showed significantly shorter DFS (mean 4.5 vs. 13.21 months, p < 0.001), and inferior overall survival (7.02 vs. 15.02 months, p < 0.001). Multivariable analysis confirmed high BAALC expression as an independent risk factor for DFS and OS.
BAALC expression is an important prognostic factor in AML patients with normal karyotype and its incorporation into novel risk-adapted therapeutic strategies will improve the currently disappointing cure rate of this group of patients.

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Available from: Raida Yahya, May 07, 2015
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    ABSTRACT: Abstract Background: Acute myeloid leukemia (AML) accounts for 25%-35% of acute leukemia in children. BAALC (Brain and Acute Leukemia Cytoplasmic gene) is a recently identified gene on chromosome 8q22.3 that has prognostic significance in AML. The aim of this work was to study the impact of BAALC gene expression on prognosis of AML in Egyptian children. Patients and methods: This study was conducted on 40 patients of newly diagnosed AML who were subjected to the following: Full history taking, clinical examination, laboratory investigations including: complete blood count, LDH, bone marrow aspiration, cytochemistry and immunophenotyping, assessment of BAALC Gene by real time PCR in bone marrow aspirate mononuclear cells before the start of chemotherapy. Results: BAALC gene expression showed positive expression in 24 cases (60%) and negative expression in 16 cases (40%). In patients with positive BAALC gene expression; 10 patients achieved complete remission, 8 patients died and 6 patients suffered from relapse, while in patients with negative BAALC gene expression; 12 patients achieved complete remission, 1 patient suffered from relapse and 3 patients died. There was significant association between BAALC gene expression and FAB classification of patients of AML patients as positive BAALC gene expression is predominantly seen in FAB subtypes M1 and M2 compared with negative BAALC gene expression that was found more in M4 (9 cases with M1, 13 cases with M2, and 3 cases with M4 in positive BAALC gene expression versus 2 cases with M1, 4 cases with M2, and 9 cases with M4 in BAALC gene negative expression group with statistically significant differences positive and negative BAALC gene expression regarding FAB subtypes). As regard age, sex, splenomegaly, lymphadenopathy, pallor, purpura, platelets count, WBCs count, and percentage of blast cells in BM, the present study showed no significant association with BAALC gene expression. Conclusion: BAALC expression is an important prognostic factor in AML patients and its incorporation into novel risk-adapted therapeutic strategies will improve the currently disappointing cure rate of this group of patients.
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