Association between BMI-1 expression, acute graft-versus-host disease, and outcome following allogeneic stem cell transplantation from HLA-identical siblings in chronic myeloid leukemia

Blood. 2008 Sep 1;112(5):2163-6. doi: 10.1182/blood-2008-04-148130. Epub 2008 Jun 18.

Abstract

Expression of CD7, ELA-2, PR-3, and the polycomb group gene BMI-1 reflects the intrinsic heterogeneity and predicts prognosis of patients with chronic myeloid leukemia (CML) who were not treated with allogeneic stem cell transplantation (allo-SCT). This study investigated whether expression of these genes determined outcome following allo-SCT in a cohort of 84 patients with chronic-phase (CP) CML. We found that patients expressing BMI-1 at a "high" level before allo-SCT had an improved overall survival (P = .005) related to a reduced transplantation-related mortality. In multivariate analysis, when adjusted for the European Group for Blood and Marrow Transplantation (EBMT)-Gratwohl score and other prog-nostic factors, there was an independent association between BMI-1 expression and grades 2 to 4 acute graft-versus-host disease (relative risk [RR] = 2.85; 95% confidence interval [CI], 1.3-6.4; P = .011), suggesting that BMI-1 measured prior to allo-SCT can serve as a biomarker for predicting outcome in patients with CP-CML receiving allo-SCT, and may thus contribute to better therapeutic decisions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Female
  • Gene Expression
  • Graft vs Host Disease / etiology*
  • Graft vs Host Disease / genetics*
  • Graft vs Host Disease / immunology
  • HLA Antigens
  • Humans
  • Leukemia, Myeloid, Chronic-Phase / genetics
  • Leukemia, Myeloid, Chronic-Phase / immunology
  • Leukemia, Myeloid, Chronic-Phase / therapy
  • Male
  • Middle Aged
  • Nuclear Proteins / genetics*
  • Polycomb Repressive Complex 1
  • Prognosis
  • Proto-Oncogene Proteins / genetics*
  • Repressor Proteins / genetics*
  • Siblings
  • Stem Cell Transplantation / adverse effects*

Substances

  • BMI1 protein, human
  • HLA Antigens
  • Nuclear Proteins
  • Proto-Oncogene Proteins
  • Repressor Proteins
  • Polycomb Repressive Complex 1