Evaluation by multivariate analysis of the differentiation inhibitory factor nm23 as a prognostic factor in acute myelogenous leukemia and application to other hematologic malignancies.
The differentiation inhibitory factor nm23 can inhibit the differentiation of murine and human myeloid leukemia cells. We recently reported that nm23 genes were overexpressed in acute myelogenous leukemia (AML), and a higher level of nm23-H1 expression was correlated with a poor prognosis in AML, especially in AML-M5 (acute monocytic leukemia). To evaluate the importance of nm23 expression as a prognostic factor in AML, we compared it with other putative prognostic factors in AML. An analysis of the correlation between nm23 expression and the clinical parameters of 110 patients with AML demonstrated that increased nm23-H1 mRNA levels were associated with resistance to initial chemotherapy and with reduced overall survival. Multivariate analysis using Cox's proportional hazard model also showed that elevated nm23-H1 mRNA levels significantly contributed to the prognosis of patients with AML. Especially in AML-M5, nm23-H1 status was the most important prognostic factor. Furthermore, to determine whether we can apply the results observed in AML to other hematologic malignancies, we investigated the relative levels of nm23-H1 and nm23-H2 transcripts in 149 patients with hematologic neoplasms, including 110 with de novo AML, 9 with de novo acute lymphoblastic leukemia, 14 with myelodysplastic syndrome, 16 with chronic myelogenous leukemia (CML), and 5 normal subjects by the reverse transcriptase-polymerase chain reaction. Expression of nm23-H1 was significantly higher in all the hematologic neoplasms, except CML in chronic phase, than in normal blood cells. nm23 may have a prognostic effect in these hematologic malignancies as well as in AML.
Yokoyama
A
A
Department of Chemotherapy, Research Institute and Hematology Clinic, Hospital, Saitama Cancer Center, Saitama, Japan.
Okabe-Kado
J
J
Wakimoto
N
N
Kobayashi
H
H
Sakashita
A
A
Maseki
N
N
Nakamaki
T
T
Hino
K i
Ki
Tomoyasu
S
S
Tsuruoka
N
N
Motoyoshi
K
K
Nagata
N
N
Honma
Y
Y
D000208:Acute Disease; D000328:Adult; D000368:Aged; D019011:Antigens, CD7 / Q000032:analysis; D014408:Biomarkers, Tumor / Q000096:biosynthesis* / Q000235:genetics; D002454:Cell Differentiation; D002869:Chromosome Aberrations; D019008:Drug Resistance, Neoplasm; D005260:Female; D015870:Gene Expression; D019337:Hematologic Neoplasms / Q000235:genetics / Q000378:metabolism / Q000401:mortality*; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007951:Leukemia, Myeloid / Q000235:genetics / Q000378:metabolism / Q000401:mortality*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D020559:Monomeric GTP-Binding Proteins; D015999:Multivariate Analysis; D009190:Myelodysplastic Syndromes / Q000235:genetics / Q000378:metabolism / Q000401:mortality; D054778:NM23 Nucleoside Diphosphate Kinases; D009363:Neoplasm Proteins / Q000096:biosynthesis* / Q000235:genetics; D009701:Nucleoside-Diphosphate Kinase; D011379:Prognosis; D016016:Proportional Hazards Models; D012333:RNA, Messenger / Q000096:biosynthesis; D012334:RNA, Neoplasm / Q000096:biosynthesis; D012074:Remission Induction; D016019:Survival Analysis; D014157:Transcription Factors / Q000096:biosynthesis* / Q000235:genetics
D019011:Antigens, CD7; D014408:Biomarkers, Tumor; D054778:NM23 Nucleoside Diphosphate Kinases; D009363:Neoplasm Proteins; D012333:RNA, Messenger; D012334:RNA, Neoplasm; D014157:Transcription Factors; D007770:L-Lactate Dehydrogenase; C517938:NME1 protein, human; D009701:Nucleoside-Diphosphate Kinase; D020559:Monomeric GTP-Binding Proteins