title: Overexpression of CXCR4 predicts adverse overall and event-free survival in patients with unmutated FLT3 acute myeloid leukemia with normal karyotype.
abstract: BACKGROUND
  CXC chemokine receptor 4 (CXCR4) expression in acute myeloid leukemia (AML) is reported to correlate with FLT3 gene mutation and poorer prognosis. The prognostic significance of CXCR4 expression in patients with AML that have a normal karyotype and no evidence of FLT3 gene mutations was examined.
  
  
  METHODS
  The prognostic significance of CXCR4 expression in 122 AML patients with normal karyotype and no evidence of FLT3 gene mutation treated at our institution between 1997 and 2003 was analyzed. All patients received intensive chemotherapy according to institutional protocols; 84% received cytarabine-containing regimens. Bone marrow biopsy or clot specimens obtained before treatment were immunostained for CXCR4.
  
  
  RESULTS
  There were 70 men and 52 women with a median age of 62 years (range, 22-82 years). Median follow-up was 18 months (range, <1-97 months). Seventy-six patients achieved complete remission (CR); 39 had recurrence. Sixty-six patients died, including 9 with no evidence of disease. CXCR4 was positive in 70 and negative in 52 patients, with CR rates of 58% and 71%, respectively (P = .09). Multivariate analysis demonstrated that CXCR4 expression, presence of multilineage dysplasia, and high creatinine level predicted poorer overall (OS) and event-free (EFS) survival. CONCLUSIONS.: The results suggest that CXCR4 expression is associated with poor prognosis in AML patients with an unmutated FLT3 gene.
authors.affiliation: Department of Hematopathology, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Sergej
authors.initials: S
authors.lastname: Konoplev
authors.forename: Georgios Z
authors.initials: GZ
authors.lastname: Rassidakis
authors.forename: Elihu
authors.initials: E
authors.lastname: Estey
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
authors.forename: Chrysoula I
authors.initials: CI
authors.lastname: Liakou
authors.forename: Xuelin
authors.initials: X
authors.lastname: Huang
authors.forename: Lianchun
authors.initials: L
authors.lastname: Xiao
authors.forename: Michael
authors.initials: M
authors.lastname: Andreeff
authors.forename: Marina
authors.initials: M
authors.lastname: Konopleva
authors.forename: L Jeffrey
authors.initials: LJ
authors.lastname: Medeiros
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011379:Prognosis; D019718:Receptors, CXCR4 / Q000032:analysis* / Q000378:metabolism*; D051941:fms-Like Tyrosine Kinase 3 / Q000235:genetics
chemical_list: D019718:Receptors, CXCR4; C497970:FLT3 protein, human; D051941:fms-Like Tyrosine Kinase 3