Background: The lack of effectiveness of acute myeloid leukemia (AML) treatment remains a major challenge and resembles a principal cause of AML-related mortality owing to chemotherapy resistance. SNAI1 has been proved to be a leading factor in drug resistance in many cancer types. However, its relation to chemoresistance in AML is not well understood.Methods: In addition to standard lab work, the expression level of SNAI1 was determined in bone marrow samples of 109 adult and pediatric patients with de novo acute myeloid leukemia using RT-qPCR. The relation between SNAI1 and AML drug resistance and immunomodulatory genes was investigated using the STRING tool.Results: The SNAI1 expression level was upregulated in AML patients in particular samples with promyelocytic leukemia subtype against control cases. In the treatment response, SNAI1 was significantly higher in resistant patients in comparison with the complete remission group. SNAI1 overexpression was associated with high initial blasts and total leukocyte counts, but with HLA class II histocompatibility antigen DR downregulation. STRING analysis showed that multiple drug resistance and immunomodulatory genes of AML induce SNAI upregulation and activation. Kaplan-Meier analysis indicated that there was no relation between SNAI1 expression level and patient survival status.
Conclusion:We conclude that the SNAI1 expression level may be a predictor of intrinsic drug resistance incidence in AML patients.acute myeloid leukemia (AML), drug resistance, HLA class II histocompatibility antigen DR (HLA-DR), immune suppression, promyelocytic leukemia (APL, AML-M3), retinoic acid receptor alpha (RAR-α), zinc finger protein SNAI1
| INTRODUCTIONAcute myeloid leukemia (AML) is a very heterogeneous malignant disease that exhibits uncontrolled clonal expansion of immature myeloid cells and ends in failure of normal hematopoiesis. 1 Leukemogenesis is thought to principally result from the accumulation of many genomic translocations and genetic mutations in hematopoietic stem cells during aging. 2 The AML incidence rate is considered to be three to five cases per 100,000 population and 68 years is the median age of diagnosis. The AML incidence rate does not change regarding race and ethnicity, but it is more common in men than women. Despite the advances in understanding the molecular mechanisms of AML development and in therapies that target it, standard AML induction regimens have remained unchanged for decades. A few years ago, new