title: Low MDR1 and BAALC expression identifies a new subgroup of intermediate cytogenetic risk acute myeloid leukemia with a favorable outcome.
abstract: Treatment optimization in acute myeloid leukemia requires the accurate assignment of patients at diagnosis to specific risk groups to guide subsequent risk-adapted treatment stratification. In this study, we have evaluated the impact of expression of the gene BAALC in conjunction with MDR1 in AML with intermediate cytogenetic risk group to more precisely define risk assessment. Low MDR1/high BAALC, high MDR1/low BAALC, and high MDR1/high BAALC expressers demonstrated a similar clinical outcome with CR rate being 68.75-75% and relapse rate being 40-50% and therefore could be considered as a "combined group". In contrast, low expression of both BAALC and MDR1 identifies an intermediate cytogenetic risk group a distinctly favorable outcome, with higher CR rate being 93.3%, lower relapse rate being 7.1%, and longer OS being 50.3% than that of the "combined group". Moreover, low MDR1/low BAALC expressers in the intermediate cytogenetic risk group also demonstrated a comparable clinical outcome with patients in the favorable-risk group. Thus low MDR1/low BAALC expression identifies a subgroup of intermediate cytogenetic risk AML patients with a remarkably good long-term outcome achieved by chemotherapy alone.
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
authors.forename: Xutao
authors.initials: X
authors.lastname: Guo
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
authors.forename: Pengcheng
authors.initials: P
authors.lastname: Shi
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
authors.forename: Feili
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zha
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
authors.forename: Bingshan
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
authors.forename: Rongwei
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
authors.forename: Huijuan
authors.initials: H
authors.lastname: Dong
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
authors.forename: Haiqing
authors.initials: H
authors.lastname: Zheng
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China. Electronic address: xubingzhangjian@126.com.
authors.forename: Bing
authors.initials: B
authors.lastname: Xu
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000235:genetics*; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D015870:Gene Expression; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000235:genetics*; D009364:Neoplasm Recurrence, Local; D063868:Patient Outcome Assessment; D011379:Prognosis; D055815:Young Adult
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; C442828:BAALC protein, human; D009363:Neoplasm Proteins
keywords: AML; BAALC; Cytogenetic risk; MDR1