Telomerase activity is prognostic in pediatric patients with acute myeloid leukemia: comparison with adult acute myeloid leukemia.
BACKGROUND
Significantly elevated telomerase activity (TA) has been found in samples from patients with almost all malignant hematologic diseases. The impact of elevated TA on the course of pediatric patients with acute myeloid leukemia (P-AML) is unknown.


METHODS
Using a modified polymerase chain reaction-based, telomeric repeat-amplification protocol assay, the authors measured TA in bone marrow samples from 40 patients with P-AML and, for comparison, in 65 adult patients with AML (A-AML), excluding patients with French-American-British M3 disease. The results were correlated with patient characteristics and survival.


RESULTS
TA in patients with P-AML was significantly lower compared with TA in patients with A-AML (P = 0.005). Patients who had P-AML with low TA had a projected 5-year survival rate of 88%, whereas patients who had P-AML with high TA had a projected 5-year survival rate of 43% (P = 0.009). Conversely, patients who had A-AML with very high TA (upper quartile) had significantly longer survival compared with patients who had A-AML with lower TA (P = 0.03). There was no correlation between complete remission rate or disease free survival and TA in P-AML or A-AML. In the A-AML group, when patients were separated by cytogenetic findings (poor prognosis vs. others), it was found that TA was significantly lower in patients with a poor prognosis, but the prognostic value of TA was not independent of cytogenetic status.


CONCLUSIONS
The current results suggest, that for patients with P-AML, bone marrow TA is a highly significant prognostic factor.
Verstovsek
Srdan
S
Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Manshouri
Taghi
T
Smith
Franklin O
FO
Giles
Francis J
FJ
Cortes
Jorge
J
Estey
Elihu
E
Kantarjian
Hagop
H
Keating
Michael
M
Jeha
Sima
S
Albitar
Maher
M
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000201:enzymology*; D002648:Child; D002675:Child, Preschool; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007223:Infant; D007951:Leukemia, Myeloid / Q000201:enzymology* / Q000473:pathology; D007958:Leukocyte Count; D008875:Middle Aged; D010976:Platelet Count; D011379:Prognosis; D019098:Telomerase / Q000097:blood / Q000378:metabolism*
D006454:Hemoglobins; D019098:Telomerase