TY - JOUR
T1 - Clinical impact of BAALC expression in high-risk acute promyelocytic leukemia
AU - Lucena-Araujo, Antonio R.
AU - Pereira-Martins, Diego A.
AU - Koury, Luisa C.
AU - Franca-Neto, Pedro L.
AU - Coelho-Silva, Juan L.
AU - De Deus Wagatsuma, Virginia M.
AU - Melo, Raul A.M.
AU - Bittencourt, Rosane
AU - Pagnano, Katia
AU - Pasquini, Ricardo
AU - Chiattone, Carlos S.
AU - Fagundes, Evandro M.
AU - De Lourdes Chauffaille, Maria
AU - Schrier, Stanley L.
AU - Tallman, Martin S.
AU - Ribeiro, Raul C.
AU - Grimwade, David
AU - Ganser, Arnold
AU - Löwenberg, Bob
AU - Lo-Coco, Francesco
AU - Sanz, Miguel A.
AU - Berliner, Nancy
AU - Rego, Eduardo M.
N1 - Funding Information:
This work was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP; grant 2013/08135-2). A.R.L.-A. received a fellowship from FAPESP (grant 2007/55067-1).
Publisher Copyright:
© 2017 by The American Society of Hematology.
PY - 2017/9/26
Y1 - 2017/9/26
N2 - Although overexpression of the brain and acute leukemia, cytoplasmic (BAALC) gene is associated with primary resistant disease and shorter relapse-free, disease-free, and overall survival in different subsets of acute myeloid leukemia (AML), little is known about its clinical impact in acute promyelocytic leukemia (APL). Using real-time reverse transcriptase polymerase chain reaction, we showed that BAALC expression is significantly lower in APL compared with other subsets of AML (P ,<.001). We also demonstrated that BAALC overexpression was associated with shorter disease-free survival (DFS) (hazard ratio [HR], 4.43; 95% confidence interval [CI], 1.29-15.2; P = .018) in 221 consecutive patients (median age, 35 years; range, 18-82 years) with newly diagnosed APL homogeneously treated with all-trans retinoic acid and anthracycline-based chemotherapy. Cox proportional hazard modeling showed that BAALC overexpression was independently associated with shorter DFS in the total cohort (HR, 5.26; 95% CI, 1.52-18.2; P = .009) and in patients with high-risk disease (ie, those with initial leukocyte counts >10 × 109/L) (HR, 5.3; 95% CI, 1.14-24.5; P = .033). We conclude that BAALC expression could be useful for refining risk stratification in APL, although this needs to be confirmed in independent cohorts.
AB - Although overexpression of the brain and acute leukemia, cytoplasmic (BAALC) gene is associated with primary resistant disease and shorter relapse-free, disease-free, and overall survival in different subsets of acute myeloid leukemia (AML), little is known about its clinical impact in acute promyelocytic leukemia (APL). Using real-time reverse transcriptase polymerase chain reaction, we showed that BAALC expression is significantly lower in APL compared with other subsets of AML (P ,<.001). We also demonstrated that BAALC overexpression was associated with shorter disease-free survival (DFS) (hazard ratio [HR], 4.43; 95% confidence interval [CI], 1.29-15.2; P = .018) in 221 consecutive patients (median age, 35 years; range, 18-82 years) with newly diagnosed APL homogeneously treated with all-trans retinoic acid and anthracycline-based chemotherapy. Cox proportional hazard modeling showed that BAALC overexpression was independently associated with shorter DFS in the total cohort (HR, 5.26; 95% CI, 1.52-18.2; P = .009) and in patients with high-risk disease (ie, those with initial leukocyte counts >10 × 109/L) (HR, 5.3; 95% CI, 1.14-24.5; P = .033). We conclude that BAALC expression could be useful for refining risk stratification in APL, although this needs to be confirmed in independent cohorts.
UR - http://www.scopus.com/inward/record.url?scp=85055355213&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055355213&partnerID=8YFLogxK
U2 - 10.1182/bloodadvances.2017005926
DO - 10.1182/bloodadvances.2017005926
M3 - Article
C2 - 29296827
AN - SCOPUS:85055355213
SN - 2473-9529
VL - 1
SP - 1807
EP - 1814
JO - Blood advances
JF - Blood advances
IS - 21
ER -