title: Expression of heat-shock proteins is associated with major adverse prognostic factors in acute myeloid leukemia.
abstract: To identify prognostic factors alternative or additional to drug-resistance and apoptosis proteins, we studied the impact of the expression of heat-shock proteins (HSPs) in 98 newly diagnosed acute myeloid leukemia (AML). HSP27 was expressed by 39%, HSP60 by 26%, HSP70 by 58%, HSP90 by 41%, and HSP110 by 30% of cases. HSP expressions were correlated with that of differentiation antigens (CD34, CD14, CD15, CD33) and that of drug-resistance (MRP, MRK) and apoptosis (Bcl-2) proteins. HSP90 and HSP110 were correlated with FAB subtype and karyotypic grouping. Complete remission (CR) was obtained in 68 cases (69%). Median disease-free survival (DFS) of the 68 remitters was 18.1 months with a 3-year DFS rate of 41%. CR rates were higher in patients with lower expression of HSPs. Overall survival (OS) was significantly longer in patients with lower expression of HSPs. Cytogenetics, CD34 positive expression, MRK positive expression, and HSP110 positive expression remained as pejorative prognostic factors for OS in the multivariate analysis. When considering patients with intermediate risk cytogenetics, HSP110 and MRP positive expressions and CD33 negative expression were of poor outcome, while HSP27 and HSP60 positive expressions appeared of pejorative prognostic value in patients with unfavorable karyotypes.
authors.affiliation: Département d'ématologie, Hôpital Edouard Herriot, Lyon Cedex 03, France. xavier.thomas@chu-lyon.fr
authors.forename: Xavier
authors.initials: X
authors.lastname: Thomas
authors.forename: Lydia
authors.initials: L
authors.lastname: Campos
authors.forename: Christiane
authors.initials: C
authors.lastname: Mounier
authors.forename: Jérome
authors.initials: J
authors.lastname: Cornillon
authors.forename: Pascale
authors.initials: P
authors.lastname: Flandrin
authors.forename: Quoc-Hung
authors.initials: QH
authors.lastname: Le
authors.forename: Simone
authors.initials: S
authors.lastname: Piselli
authors.forename: Denis
authors.initials: D
authors.lastname: Guyotat
mesh_terms: D000208:Acute Disease; D001854:Bone Marrow Cells / Q000378:metabolism; D018572:Disease-Free Survival; D005260:Female; D005434:Flow Cytometry; D006360:Heat-Shock Proteins / Q000378:metabolism*; D006801:Humans; D007951:Leukemia, Myeloid / Q000378:metabolism / Q000473:pathology*; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis
chemical_list: D006360:Heat-Shock Proteins