Identification of a new prognostic factor in Acute Myeloid Leukemia


Acute myeloid leukemia (AML) is a malignant blood cell disorder with a current 5 year survival of less than 40%. The identification of genetically defined prognostic factors has contributed to individualized treatment strategies and improved disease outcome in AML, however, improvements are still needed. Researchers from the Laboratory of Hematology report on the identification of a novel favorable prognostic factor in AML: high expression of the BRCA1 complex member BRE (Blood, early edition article). The 5 year survival of patients with highBRE expression was 57%. HighBRE expression was often observed in patients that had a chromosomal translocation leading to theMLL-AF9 fusion gene. The prognostic value ofBRE was especially strong within theMLL-AF9 group:BRE+/MLL-AF9+ patients exhibited a superior 5 year survival of 80% while the 5 year survival forBRE-/MLL-AF9+ patients was 0% (see accompanying figure). Importantly, patients with high BRE expression were further characterized by a similar gene expression profile. In conclusion, the authors identify a new molecularly defined subtype of AML with favorable prognosis, characterized by highBRE expression. This work may have implications for future risk stratification and treatment strategies of AML.

Sylvie M. Noordermeer, Mathijs A. Sanders, Christian Gilissen, Evelyn Tönnissen, Adrian van der Heijden, Konstanze Döhner, Lars Bullinger, Joop H. Jansen, Peter J. M. Valk, Bert A. van der Reijden:

High BREexpression predicts favorable outcome in adult acute myeloid leukemia, in particular among MLL-AF9positive patients, Blood, published ahead of print September 21, 2011, doi:10.1182/blood-2011-06-359182



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