The Prognostic Significance of the BMI-1 and BAALC Genes in Adult Patients with Acute Myeloid Leukemia

Abstract

The aim of this work is to investigate the different expression patterns of B cell-specifics moloney murine Leukemia virus integration site-1 (BMI-1) and brain and acute leukemia, cytoplasmic (BAALC) genes, their prognostic and clinical significance in newly diagnosed cytogenetically heterogenous adult acute myeloid leukemia patients. BMI-1 and BAALC expression was detected in the bone marrow of patients using quantitative real-time reverse transcription polymerase chain reaction with cut off value set at 50th percentile for both genes. BMI-1 and BAALC overexpression was detected in 50% of cases which suggest their potential as molecular markers. A statistical significant correlation was found between BMI-1 expression with hepatomegaly (P value = 0.007), hemoglobin level-grouped (P value = 0.047) and cytogenetic risk groups (P value = 0.036). There was a statistically significant correlation between BAALC and age (P value = 0.015), lymphadenopathy (P value = 0.043), CD34 expression (P value = 0.003) and near statistical significance with FAB sub-groups (P value = 0.054). No statistical significance was noted for other hematological findings and response to treatment except for BAALC gene and treatment response (P value = 0.014). No statistical significance in overall survival and disease free survival for both genes was found. Their prospective screening in combination with other molecular markers can help refine myeloid leukemia staging and prognosis toward optimizing therapeutic interventions.

The Role of BAALC Gene in the Transformation of Myeloid Progenitor Cells to Acute Myeloid Leukemia

“…In some of them, the authors found a trend that high BAALC expressers are younger age than the low expressers [10]. In an analysis from Shafik et al a statistical significance between BAALC and age, CD34 expression, and close to significant results with some of FAB sub-groups was found [27].…”

“…Therefore, BAALC overexpression and the FLT3 mutation is an objects of many studies. Some of them [14,23,27,28], failed to find a link between BAALC and FLT3-ITD, but opposing this conclusion, other authors provide results concluding that there is a strong correlation between high BAALC expression and the FLT3-ITD mutation [10,29,30].…”