Relevance of plasma bone marrow Activin-A and CXCL-12 concentration levels as a biomarker in acute myeloid leukemia.

Background: Acute myeloid leukemia changes the bone marrow (BM) niche to support leukemia cells by modulating the stromal microenvironment. The aim is to assess Activin-A as a biomarker in acute myeloid leukemia (AML).

Methods: The level of Activin-A and CXCL-12 protein concentration levels in the plasma of bone marrow aspirate samples of eighty AML patients at diagnosis, after induction and at relapse were determined by ELISA.

Results: We found that Activin-A concentration levels was significantly up regulated in AML cases at diagnosis, and down regulated at complete remission and rise again at relapse (P< 0.001). In contrast; the CXCL-12 gene expression was significantly down regulated in AML cases at diagnosis; relapse, and up regulated after complete remission (P< 0.001). Multivariate analysis showed that high Activin-A levels at diagnosis is significant predictor of induction of remission response OR 1.006 (CI: 1.002-1.010) (P= 0.003); AML relapse OR 1.002 (CI: 1.0-1.004) (P= 0.043) as well as patients' outcome OR 1.33 (CI: 1.004-1.062) (P= 0.024).

Conclusion: Activin-A level at diagnosis is a new simple easily assessed biomarker that could predict AML patient's response to therapy as well as patient's outcome.