[Expression of antigen CD40 and survivin gene and their clinical implications in acute myeloid leukemia].

Objective: To evaluate the expressions of CD40 antigen and anti-apoptosis gene survivin in acute myeloid leukemia (AML) and their clinical significance.

Methods: By using flow cytometry (FCM) and reverse transcriptase polymerase chain reaction (RT-PCR), CD40 antigen and anti-apoptosis gene survivin mRNA were studied in 48 AML cases and their association with the clinical features of AML was analysed.

Results: (1) In the 48 AML cases, positive expression of CD40 antigen was found in 25 cases (52.1%) and positive expression of anti-apoptosis gene survivin mRNA in 35 cases (72.9%). (2) The incidence of splenomegaly, thrombocytopenia and hyperleukocytosis in CD40+ AML cases was significantly higher than those in CD40- AML ones (36.0% vs 8.7%), P=0.025; (72.0% vs 43.5%), P=0.045; (32.0% vs 4.4%), P=0.024. (3) There was no difference in the number of the expression of survivin mRNA between CD40+ AML cases and CD40- AML ones (20/25 vs 15/23) P=0.25, but the expression of survivin mRNA of both the groups was high than those of normal controls (20/25 vs 6/20), P=0.001; (15/23 vs 6/20), P=0.021. In the 48 AML cases the rate of the expression of CD40 antigen was less than those of anti-apoptosis gene survivin mRNA (52.1% vs 72.9%), P=0.041. (4) The complete remission (CR) rate in the survivin+ AML cases receiving chemotherapy was significantly less than that in the survivin- AML ones (31.4% vs 69.2%), P=0.018.

Conclusions: The expression of CD40 antigen might be associated with some unfavorable clinical features of AML. The expression of anti-apoptosis gene survivin might be one of the reasons that AML have a lower CR rate, and it is one of the prognostic factors in AML.