Abstract
Background:Resistance to chemotherapy is a major obstacle to curing acute myeloid leukaemia (AML), and several antigens are claimed to play primary roles in this resistance.Purpose:The aim of this study was to evaluate the roles of CD56, CD11b and Smac/DIABLO gene expression levels as prognostic markers of the clinical outcome, response to chemotherapy and survival of AML patients.Materials and Methods:A cross-sectional observational study was conducted on 60 naïve-AML patients who received induction therapy with mitoxantrone and cytarabine combined with a high dose of cytarabine. The CD56,CD11b and Smac/DIABLO expression levels were assessed using flow cytometry at diagnosis and were analysed for correlation with the possible associated risk factors, response to chemotherapy, and median duration of disease-free survival (DFS) and overall survival (OS).Results:The overall results revealed that AML patients who exhibited positive expression for CD56 and CD11b had short median durations of DFS and OS.(P = 0.019, 0.006, 0.029 and 0.024, respectively). Additionally, low Smac/DIABLO expression had a negative impact on treatment outcome in terms of CR rate (p=0.012) and reduced DFS (p=0.000) and OS(p=0.000) values.Conclusions:CD56 and CD11b positivity and low Smac/DIABLO expression are important predictive factors for the occurrence of chemoresistance, in addition to other risk factors, among AML patients.
Highlights
Resistance to chemotherapy is a main obstacle to curing acute myeloid leukaemia (AML)
CD11b is thought play an important role in the regulation of the biology of malignant AML cells and the expression level of CD11b may affect the prognosis of AML patients
The present study was conducted on sixty AML patients, 39 of whom were males and 21 were females with a median age of 32 years
Summary
Resistance to chemotherapy is a main obstacle to curing acute myeloid leukaemia (AML). Inherited or acquired genomic alterations lead to the synthesis of gene products responsible for reduced drug sensitivity (Tsuruo, 1988; Gottesman and Pastan,1988) Among these gene products, the CD56 antigen, an isoform of the neural adhesion molecule on leukaemic blasts, has been proven by some studies to be an independent adverse prognostic factor for the achievement and duration of complete remission (CR), in even good-risk patients (Baer et al, 1997; Raspadori et al, 2001; Di Bona et al, 2002). Conclusions: CD56 and CD11b positivity and low Smac/DIABLO expression are important predictive factors for the occurrence of chemoresistance, in addition to other risk factors, among AML patients
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