Role of homeobox-A9 gene expression in patients with de novo acute myeloid leukemia

Abstract

ObjectiveTo study the clinical significance and the prognostic value of homeobox-A9 (HOXA9) gene in patients with newly diagnosed acute myeloid leukemia (AML).BackgroundHOX genes are transcription factors. In humans, the 39 HOX genes are organized into four genomic regions (the HOXA, B, C and D clusters), located on four chromosomes (chromosomes 7, 17, 12, and 2, respectively). They play important roles during embryogenesis. The characteristic expression of HOX genes can also be detected in different adult tissues.Patients and methodsThis prospective case–control study was conducted on 60 patients with newly diagnosed AML and 40 healthy patients serving as a control group. They underwent a full history, clinical examination, complete blood count, bone marrow examination, and quantification of HOXA9 in blood by quantitative real-time PCR assay.ResultsFrom the results of this study, we found that HOXA9 was higher in patients with AML than healthy controls (P < 0.001). The highest incidence was found in AML M7 and M5, in patients with AML with older age, with hepatomegaly and splenomegaly, in patients with AML with unfavorable cytogenetic criteria, and in patients with AML who did not achieve complete remission.ConclusionHOXA9 is higher in patients with AML than controls. High HOXA9 expression has a negative prognostic effect on patients with AML and poorer response to chemotherapy. Moreover, it represents an independent prognostic factor mediating chemotherapy.