title: Clinical and pathological correlations of marrow PUMA and P53 expressions in myelodysplastic syndromes.
abstract: p53 is a key regulator of apoptosis. p53 upregulated modulator of apoptosis (PUMA) is a critical mediator of p53-dependent and independent apoptosis. The objective of this study was to evaluate the relationship of p53 and PUMA to the prognosis of MDS. Bone marrow biopsies of MDS patients at the time of diagnosis (n = 76) and at the time of transformation (n = 19) were included in the study group. The expression of p53 and PUMA was evaluated using immunohistochemistry. When compared to the control group, both p53 (p < 0.001) and PUMA (p = 0.012) expression levels were significantly higher in MDS group. In MDS group, there was a moderate positive correlation between p53 and PUMA expressions. PUMA expression was not correlated with event free and overall survival. However, overall survival was significantly lower in cases with p53 expression in more than 50% of the cells. There was an increase in PUMA expression in cases that showed transformation as compared to the initial diagnostic bone marrows but was not statistically significant. The correlation that existed between p53 and PUMA was lost in transformed cases. Our results showed that PUMA and p53 expressions are increased in MDS marrows compared to normal marrows. PUMA expression increases further during transformation while the expression of p53 is not significantly altered which suggests that PUMA alterations might be a late event during the evolution of MDS.
authors.affiliation: Faculty of Medicine, Hacettepe University Division of Adult Hematology, Ankara, Turkey.
authors.forename: Ozlen
authors.initials: O
authors.lastname: Bektas
authors.forename: Aysegul
authors.initials: A
authors.lastname: Uner
authors.forename: Yahya
authors.initials: Y
authors.lastname: Buyukasik
authors.forename: Burak
authors.initials: B
authors.lastname: Uz
authors.forename: Sureyya
authors.initials: S
authors.lastname: Bozkurt
authors.forename: Eylem
authors.initials: E
authors.lastname: Eliacik
authors.forename: Ayse
authors.initials: A
authors.lastname: Işik
authors.forename: Ibrahim Celalettin
authors.initials: IC
authors.lastname: Haznedaroglu
authors.forename: Hakan
authors.initials: H
authors.lastname: Goker
authors.forename: Haluk
authors.initials: H
authors.lastname: Demiroglu
authors.forename: Salih
authors.initials: S
authors.lastname: Aksu
authors.forename: Osman Ilhami
authors.initials: OI
authors.lastname: Ozcebe
authors.forename: Nilgun
authors.initials: N
authors.lastname: Sayinalp
mesh_terms: D000368:Aged; D051017:Apoptosis Regulatory Proteins / Q000378:metabolism*; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology*; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000378:metabolism*; D013997:Time Factors; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
chemical_list: D051017:Apoptosis Regulatory Proteins; C438378:BBC3 protein, human; D011518:Proto-Oncogene Proteins; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53
keywords: MDS; PUMA; apoptosis; diagnostic; fibrosis; immunohistochemistry; p53; prognosis