Clinical impact of BAALC expression in high-risk acute promyelocytic leukemia

Antonio R. Lucena-Araujo, Diego A. Pereira-Martins, Luisa C. Koury, Pedro L. Franca-Neto, Juan L. Coelho-Silva, Virginia M. De Deus Wagatsuma, Raul A.M. Melo, Rosane Bittencourt, Katia Pagnano, Ricardo Pasquini, Carlos S. Chiattone, Evandro M. Fagundes, Maria De Lourdes Chauffaille, Stanley L. Schrier, Martin S. Tallman, Raul C. Ribeiro, David Grimwade, Arnold Ganser, Bob Löwenberg, Francesco Lo-CocoMiguel A. Sanz, Nancy Berliner, Eduardo M. Rego*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1807-1814
Number of pages8
JournalBlood Advances
Issue number21
StatePublished - Sep 26 2017

ASJC Scopus subject areas

  • Hematology


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