APRIL gene expression in a cohort of Egyptian acute myeloid leukemia patients: Clinical and prognostic significance

Abstract

APRIL (A Proliferation Inducing Ligand) is a member of the tumor necrosis factor (TNF) family. It is essential for the survival of normal and malignant B lymphocytes. Increased expression of APRIL is noted in most of hematological malignancies and auto immune diseases. We investigated the expression level of APRIL mRNA in 50 de novo acute myeloid leukemia (AML) patients, together with 20 healthy controls using a Real-Time Quantitative Reverse-Transcriptase Polymerase Chain Reaction (RTQ-PCR) with a specific aim of determining its relation to clinical features and laboratory findings at diagnosis and its impact on the response to therapy. APRIL mRNA expression level was significantly higher in AML patients than in controls (p = < 0.001). APRIL expression level was significantly higher in patients who didn't achieve CR compared to those who achieved CR (p < 0.001). Patients who did not achieve CR also had higher TLC, lower platelets and older age than CR patients. The difference was statistically significant (p < 0.001, p = 0.047, p = 0.019) respectively. APRIL levels showed significant positive correlation with TLC (r = 0.743.p < 0.001), with age (r = 0.296,p = 0.037) and a negative correlation with platelets count (r = -0.443,p = 0.001) and no correlation with gender, Hb level, BM blast, HSM or LNs enlargement. Our study has shown that APRIL is overexpressed in AML patients, its level might serve as an indicator for disease progression. APRIL might be an indicator for poor prognosis and treatment resistance in AML patient; therefore, APRIL antagonists may represent a novel therapeutic approach for the treatment of AML.