Clinical impact of BAALC expression in high-risk acute promyelocytic leukemia.
Antonio R Lucena-AraujoDiego A Pereira-MartinsLuisa C KouryPedro L Franca-NetoJuan L Coelho-SilvaVirginia M de Deus WagatsumaRaul A M MeloRosane BittencourtKatia PagnanoRicardo PasquiniCarlos S ChiattoneEvandro M FagundesMaria de Lourdes ChauffailleStanley L SchrierMartin S TallmanRaul C RibeiroDavid GrimwadeArnold GanserBob LöwenbergFrancesco Lo-CocoMiguel A SanzNancy BerlinerEduardo Magalhaes RegoPublished in: Blood advances (2017)
Although overexpression of the brain and acute leukemia, cytoplasmic (BAALC) gene is associated with primary resistant disease and shorter relapse-free, disease-free, and overall survival in different subsets of acute myeloid leukemia (AML), little is known about its clinical impact in acute promyelocytic leukemia (APL). Using real-time reverse transcriptase polymerase chain reaction, we showed that BAALC expression is significantly lower in APL compared with other subsets of AML (P < .001). We also demonstrated that BAALC overexpression was associated with shorter disease-free survival (DFS) (hazard ratio [HR], 4.43; 95% confidence interval [CI], 1.29-15.2; P = .018) in 221 consecutive patients (median age, 35 years; range, 18-82 years) with newly diagnosed APL homogeneously treated with all-trans retinoic acid and anthracycline-based chemotherapy. Cox proportional hazard modeling showed that BAALC overexpression was independently associated with shorter DFS in the total cohort (HR, 5.26; 95% CI, 1.52-18.2; P = .009) and in patients with high-risk disease (ie, those with initial leukocyte counts >10 × 109/L) (HR, 5.3; 95% CI, 1.14-24.5; P = .033). We conclude that BAALC expression could be useful for refining risk stratification in APL, although this needs to be confirmed in independent cohorts.
Keyphrases
- drug induced
- acute myeloid leukemia
- newly diagnosed
- free survival
- poor prognosis
- cell proliferation
- peripheral blood
- bone marrow
- transcription factor
- end stage renal disease
- binding protein
- gene expression
- prognostic factors
- genome wide
- chronic kidney disease
- liver failure
- brain injury
- long non coding rna
- blood brain barrier
- patient reported outcomes
- cerebral ischemia
- patient reported
- acute lymphoblastic leukemia
- resting state
- extracorporeal membrane oxygenation
- functional connectivity