Background: Acute myeloid leukemia (AML) is a heterogeneous hematologic malignancy. Protein phosphatase 2A Protein phosphatase 2A (PP2A) is a major serine/threonine phosphatase and tumor suppressor that negatively regulates numerous signal transduction pathways. Cancerous inhibitor of PP2A (CIP2A) is an endogenous inhibitor of PP2A. CIP2A overexpression was shown to be a recurrent event in cytogenetic normal AML patients. The aim of the study is to evaluate the prognostic significance of CIP2A overexpression in patients with AML.
Research design and methods: The study included 174 newly diagnosed cytogenetic normal AML patients. Detection of CIP2A expression was performed using quantitative real-time PCR.
Results: CIP2A was overexpressed in 125/174 (71.8%) of patients. Correlation of CIP2A overexpression with other prognostic factors showed significant association with CD34 expression (p = 0.04). CIP2A overexpression was significantly associated with a lower rate of (complete remission) CR (p = 0.019) and shorter disease free survival (DFS) and overall survival (OS) (p < 0.001 and <0.001, respectively). In multivariate analysis, CIP2A overexpression was an independent adverse prognostic factor that negatively affected DFS and OS (p < 0.001, HR:2.8,95%CI:1.7-4.7 and p = 0.002, HR:1.8; 95%CI:1.2-2.65, respectively).
Conclusion: CIP2A overexpression is a useful prognostic marker in AML.
Keywords: Acute myeloid leukemia; CIP2A; PP2A; prognosis.