A molecular risk score integrating BAALC, ERG and WT1 expression levels for risk stratification in acute promyelocytic leukemia

Anna Hecht; Daniel Nowak; Verena Nowak; Benjamin Hanfstein; Thomas Büchner; Karsten Spiekermann; Christel Weiß; Wolf-Karsten Hofmann; Eva Lengfelder; Florian Nolte

doi:10.1016/j.leukres.2015.08.010

A molecular risk score integrating BAALC, ERG and WT1 expression levels for risk stratification in acute promyelocytic leukemia

Leuk Res. 2015 Aug 20:S0145-2126(15)30363-5. doi: 10.1016/j.leukres.2015.08.010. Online ahead of print.

Affiliations

¹ Department of Hematology and Oncology, University Hospital Mannheim, University of Heidelberg, Germany. Electronic address: anna.hecht@medma.uni-heidelberg.de.
² Department of Hematology and Oncology, University Hospital Mannheim, University of Heidelberg, Germany.
³ Department of Hematology/Oncology, University of Münster, Münster, Germany.
⁴ Department of Hematology/Oncology, University of Munich, Munich, Germany.
⁵ Department for Medical Statistics and Biomathematics, Medical Faculty Mannheim, University of Heidelberg, Germany.

PMID: 26344466
DOI: 10.1016/j.leukres.2015.08.010

Abstract

To date risk stratification in acute promyelocytic leukemia (APL) is based on highly dynamic leukocyte and platelet counts only. To identify a more robust risk stratification model, a molecular risk score was developed based on expression levels of the genes BAALC, ERG and WT1. Hereby, the main focus was on prediction of relapse. The integrative risk score divided patients into two groups with highly significant differences in outcome. It discriminated a high risk group with a high incidence of relapse successfully from a low risk group with no APL-related events after achievement of first remission. Especially the concurrent presence of molecular risk factors showed to be a negative prognostic factor in APL. The molecular risk score might be a promising approach to guide monitoring of APL patients and therapeutic decisions in the future.

Keywords: Acute promyelocytic leukemia; Molecular risk factors; Prognosis; Relapse; Survival.