The influence of BCL2, BAX, and ABCB1 gene expression on prognosis of adult de novo acute myeloid leukemia with normal karyotype patients.

Background: Deregulation of the apoptotic process underlies the pathogenesis of many cancers, including leukemia, but is also very important for the success of chemotherapy treatment. Therefore, the gene expression profile of main apoptotic factors, such as anti-apoptotic (B-cell lymphoma protein 2) and pro-apoptotic (BCL2-associated X), as well as genes involved in the multi-drug resistance (), could have significant impact on the prognosis and could be used as targets for specific therapy.

Patients And Methods: We analyzed the expression of , and in bone-marrow samples collected at diagnosis from 51 adult patients with acute myeloid leukemia with normal karyotype (AML-NK) using real-time polymerase chain reaction method, and examined their prognostic potential.

Results: Increased expression of ( ) was associated with the presence of chemoresistance (p = 0.024), while patients with low expression were more prone to relapse (p = 0.047). Analysis of the combined effect of and expression showed that 87% of patients with status were resistant to therapy (p = 0.044). High expression of was associated with status (p < 0.001), and with absence mutations (p = 0.019).

Conclusions: The present analysis of , and gene expression profiles is the first study focusing solely on AML-NK patients. Preliminary results showed that patients with high expression are likely to experience resistance to chemotherapy, and may benefit from specific anti-BCL2 treatment. Further investigations conducted on a larger number of patients could elucidate actual prognostic significance of these genes in AML-NK patients.