Clinical impact of BAALC expression in high-risk acute promyelocytic leukemia

Antonio R Lucena-Araujo, Diego A Pereira-Martins, Luisa C Koury, Pedro L Franca-Neto, Juan L Coelho-Silva, Virginia M de Deus Wagatsuma, Raul A M Melo, Rosane Bittencourt, Katia Pagnano, Ricardo Pasquini, Carlos S Chiattone, Evandro M Fagundes, Maria de Lourdes Chauffaille, Stanley L Schrier, Martin S Tallman, Raul C Ribeiro, David Grimwade, Arnold Ganser, Bob Löwenberg, Francesco Lo-Coco & 3 others Miguel A Sanz, Nancy Berliner, Eduardo M Rego

Research output: Contribution to journalArticle

Abstract

Although overexpression of the brain and acute leukemia, cytoplasmic (BAALC) gene is associated with primary resistant disease and shorter relapse-free, disease-free, and overall survival in different subsets of acute myeloid leukemia (AML), little is known about its clinical impact in acute promyelocytic leukemia (APL). Using real-time reverse transcriptase polymerase chain reaction, we showed that BAALC expression is significantly lower in APL compared with other subsets of AML (P < .001). We also demonstrated that BAALC overexpression was associated with shorter disease-free survival (DFS) (hazard ratio [HR], 4.43; 95% confidence interval [CI], 1.29-15.2; P = .018) in 221 consecutive patients (median age, 35 years; range, 18-82 years) with newly diagnosed APL homogeneously treated with all-trans retinoic acid and anthracycline-based chemotherapy. Cox proportional hazard modeling showed that BAALC overexpression was independently associated with shorter DFS in the total cohort (HR, 5.26; 95% CI, 1.52-18.2; P = .009) and in patients with high-risk disease (ie, those with initial leukocyte counts >10 × 109/L) (HR, 5.3; 95% CI, 1.14-24.5; P = .033). We conclude that BAALC expression could be useful for refining risk stratification in APL, although this needs to be confirmed in independent cohorts.

Original languageEnglish
Pages (from-to)1807-1814
Number of pages8
JournalBlood
Volume1
Issue number21
DOIs
Publication statusPublished - Sep 26 2017

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Acute Promyelocytic Leukemia
Brain
Leukemia
Acute Myeloid Leukemia
Polymerase chain reaction
RNA-Directed DNA Polymerase
Reverse Transcriptase Polymerase Chain Reaction
Refining
Disease-Free Survival
Real-Time Polymerase Chain Reaction
Genes
Recurrence

Keywords

  • Journal Article

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Lucena-Araujo, A. R., Pereira-Martins, D. A., Koury, L. C., Franca-Neto, P. L., Coelho-Silva, J. L., de Deus Wagatsuma, V. M., ... Rego, E. M. (2017). Clinical impact of BAALC expression in high-risk acute promyelocytic leukemia. Blood, 1(21), 1807-1814. https://doi.org/10.1182/bloodadvances.2017005926

Clinical impact of BAALC expression in high-risk acute promyelocytic leukemia. / Lucena-Araujo, Antonio R; Pereira-Martins, Diego A; Koury, Luisa C; Franca-Neto, Pedro L; Coelho-Silva, Juan L; de Deus Wagatsuma, Virginia M; Melo, Raul A M; Bittencourt, Rosane; Pagnano, Katia; Pasquini, Ricardo; Chiattone, Carlos S; Fagundes, Evandro M; Chauffaille, Maria de Lourdes; Schrier, Stanley L; Tallman, Martin S; Ribeiro, Raul C; Grimwade, David; Ganser, Arnold; Löwenberg, Bob; Lo-Coco, Francesco; Sanz, Miguel A; Berliner, Nancy; Rego, Eduardo M.

In: Blood, Vol. 1, No. 21, 26.09.2017, p. 1807-1814.

Research output: Contribution to journalArticle

Lucena-Araujo, AR, Pereira-Martins, DA, Koury, LC, Franca-Neto, PL, Coelho-Silva, JL, de Deus Wagatsuma, VM, Melo, RAM, Bittencourt, R, Pagnano, K, Pasquini, R, Chiattone, CS, Fagundes, EM, Chauffaille, MDL, Schrier, SL, Tallman, MS, Ribeiro, RC, Grimwade, D, Ganser, A, Löwenberg, B, Lo-Coco, F, Sanz, MA, Berliner, N & Rego, EM 2017, 'Clinical impact of BAALC expression in high-risk acute promyelocytic leukemia', Blood, vol. 1, no. 21, pp. 1807-1814. https://doi.org/10.1182/bloodadvances.2017005926
Lucena-Araujo AR, Pereira-Martins DA, Koury LC, Franca-Neto PL, Coelho-Silva JL, de Deus Wagatsuma VM et al. Clinical impact of BAALC expression in high-risk acute promyelocytic leukemia. Blood. 2017 Sep 26;1(21):1807-1814. https://doi.org/10.1182/bloodadvances.2017005926
Lucena-Araujo, Antonio R ; Pereira-Martins, Diego A ; Koury, Luisa C ; Franca-Neto, Pedro L ; Coelho-Silva, Juan L ; de Deus Wagatsuma, Virginia M ; Melo, Raul A M ; Bittencourt, Rosane ; Pagnano, Katia ; Pasquini, Ricardo ; Chiattone, Carlos S ; Fagundes, Evandro M ; Chauffaille, Maria de Lourdes ; Schrier, Stanley L ; Tallman, Martin S ; Ribeiro, Raul C ; Grimwade, David ; Ganser, Arnold ; Löwenberg, Bob ; Lo-Coco, Francesco ; Sanz, Miguel A ; Berliner, Nancy ; Rego, Eduardo M. / Clinical impact of BAALC expression in high-risk acute promyelocytic leukemia. In: Blood. 2017 ; Vol. 1, No. 21. pp. 1807-1814.
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T1 - Clinical impact of BAALC expression in high-risk acute promyelocytic leukemia

AU - Lucena-Araujo, Antonio R

AU - Pereira-Martins, Diego A

AU - Koury, Luisa C

AU - Franca-Neto, Pedro L

AU - Coelho-Silva, Juan L

AU - de Deus Wagatsuma, Virginia M

AU - Melo, Raul A M

AU - Bittencourt, Rosane

AU - Pagnano, Katia

AU - Pasquini, Ricardo

AU - Chiattone, Carlos S

AU - Fagundes, Evandro M

AU - Chauffaille, Maria de Lourdes

AU - Schrier, Stanley L

AU - Tallman, Martin S

AU - Ribeiro, Raul C

AU - Grimwade, David

AU - Ganser, Arnold

AU - Löwenberg, Bob

AU - Lo-Coco, Francesco

AU - Sanz, Miguel A

AU - Berliner, Nancy

AU - Rego, Eduardo M

PY - 2017/9/26

Y1 - 2017/9/26

N2 - Although overexpression of the brain and acute leukemia, cytoplasmic (BAALC) gene is associated with primary resistant disease and shorter relapse-free, disease-free, and overall survival in different subsets of acute myeloid leukemia (AML), little is known about its clinical impact in acute promyelocytic leukemia (APL). Using real-time reverse transcriptase polymerase chain reaction, we showed that BAALC expression is significantly lower in APL compared with other subsets of AML (P < .001). We also demonstrated that BAALC overexpression was associated with shorter disease-free survival (DFS) (hazard ratio [HR], 4.43; 95% confidence interval [CI], 1.29-15.2; P = .018) in 221 consecutive patients (median age, 35 years; range, 18-82 years) with newly diagnosed APL homogeneously treated with all-trans retinoic acid and anthracycline-based chemotherapy. Cox proportional hazard modeling showed that BAALC overexpression was independently associated with shorter DFS in the total cohort (HR, 5.26; 95% CI, 1.52-18.2; P = .009) and in patients with high-risk disease (ie, those with initial leukocyte counts >10 × 109/L) (HR, 5.3; 95% CI, 1.14-24.5; P = .033). We conclude that BAALC expression could be useful for refining risk stratification in APL, although this needs to be confirmed in independent cohorts.

AB - Although overexpression of the brain and acute leukemia, cytoplasmic (BAALC) gene is associated with primary resistant disease and shorter relapse-free, disease-free, and overall survival in different subsets of acute myeloid leukemia (AML), little is known about its clinical impact in acute promyelocytic leukemia (APL). Using real-time reverse transcriptase polymerase chain reaction, we showed that BAALC expression is significantly lower in APL compared with other subsets of AML (P < .001). We also demonstrated that BAALC overexpression was associated with shorter disease-free survival (DFS) (hazard ratio [HR], 4.43; 95% confidence interval [CI], 1.29-15.2; P = .018) in 221 consecutive patients (median age, 35 years; range, 18-82 years) with newly diagnosed APL homogeneously treated with all-trans retinoic acid and anthracycline-based chemotherapy. Cox proportional hazard modeling showed that BAALC overexpression was independently associated with shorter DFS in the total cohort (HR, 5.26; 95% CI, 1.52-18.2; P = .009) and in patients with high-risk disease (ie, those with initial leukocyte counts >10 × 109/L) (HR, 5.3; 95% CI, 1.14-24.5; P = .033). We conclude that BAALC expression could be useful for refining risk stratification in APL, although this needs to be confirmed in independent cohorts.

KW - Journal Article

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DO - 10.1182/bloodadvances.2017005926

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