Refinement of Risk-Stratification of Cytogenetically Normal Acute Myeloid Leukemia Adult Patients by MN1 Expression

Asian Pac J Cancer Prev. 2024 Jul 1;25(7):2283-2289. doi: 10.31557/APJCP.2024.25.7.2283.

Abstract

Introduction: Acute myeloid leukemia with normal cytogenetics (CN-AML) represents a heterogeneous group having diverse genetic mutations. Understanding the significance of each of these mutations is necessary. In this study, we evaluated the prognostic role of MN1 expression in adult CN-AML patients.

Method: One hundred and sixty-three de-novo adult AML patients were evaluated for MN1 expression by real-time PCR. MN1 expression was correlated with the clinical characteristics of the patients and their outcomes.

Results: Higher MN1 expression was associated with NPM1 wild-type (p<0.0001), CD34 positivity (p=0.006), and lower clinical remission rate (p=0.027). FLT3-ITD and CEBPA mutations had no association with MN1 expression. On survival analysis, a high MN1 expression was associated with poor event-free survival (Hazard Ratio 2.47, 95% Confidence Interval: 1.42-4.3; p<0.0001) and overall survival (Hazard Ratio 4.18, 95% Confidence Interval: 2.17-8.08; p<0.0001). On multivariate analysis, the MN1 copy number emerged as an independent predictor of EFS (p<0.0001) and OS (p<0.0001).

Conclusion: MN1 expression is an independent predictor of outcome in CN-AML.

Keywords: BAALC; CEBPA; FLT3; Genetics; NPM1.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor* / genetics
  • Biomarkers, Tumor* / metabolism
  • CCAAT-Enhancer-Binding Proteins / genetics
  • CCAAT-Enhancer-Binding Proteins / metabolism
  • Female
  • Follow-Up Studies
  • Humans
  • Leukemia, Myeloid, Acute* / genetics
  • Leukemia, Myeloid, Acute* / pathology
  • Male
  • Middle Aged
  • Mutation
  • Nuclear Proteins / genetics
  • Nuclear Proteins / metabolism
  • Nucleophosmin*
  • Prognosis
  • Risk Assessment
  • Survival Rate
  • Trans-Activators* / genetics
  • Tumor Suppressor Proteins* / genetics
  • Tumor Suppressor Proteins* / metabolism
  • Young Adult
  • fms-Like Tyrosine Kinase 3 / genetics
  • fms-Like Tyrosine Kinase 3 / metabolism

Substances

  • MN1 protein, human
  • Nucleophosmin
  • Tumor Suppressor Proteins
  • NPM1 protein, human
  • Trans-Activators
  • Biomarkers, Tumor
  • CCAAT-Enhancer-Binding Proteins
  • fms-Like Tyrosine Kinase 3
  • Nuclear Proteins