Prognostic significance of the family expression in acute myeloid leukemia.

BACKGROUND

Acute myeloid leukemia (AML) is a highly heterogenous hematological malignancy and its prognostication depends on the genetic mutation and expression profile of each patient. Pantothenate kinase () is a regulatory enzyme that controls coenzyme A (CoA) biosynthesis. It has four isoforms encoded by , respectively. Whether the expression of the family has prognostic significance in AML remains unclear.

METHODS

We screened The Cancer Genome Atlas database for AML patients with complete expression data. Eighty-four AML patients met the criteria and were included in this study. Clinical characteristics at diagnosis, including peripheral blood (PB) white blood cell counts (WBC), blast percentages in PB and bone marrow (BM), French-American-British (FAB) subtypes and the frequencies of common genetic mutations were described. Survival was estimated using the Kaplan-Meier method and the log-rank test. Multivariate Cox proportional hazard models were constructed for event-free survival (EFS) and overall survival (OS), using a limited backward elimination procedure.

RESULTS

Patients with high expression had significantly longer event-free survival (EFS) and overall survival (OS) than patients with low expression (P=0.007, P=0.016, respectively), whereas patients with high expression had shorter EFS and OS than patients with low expression (P=0.022, P=0.015, respectively). Multivariate analysis confirmed that high expression was an independent risk factor for EFS and OS (both P<0.05).

CONCLUSIONS

Our study suggested that high expression might have favorable effects on AML, while high expression was indicative of poor prognosis.