The Prognostic Significance of the BMI-1 and BAALC Genes in Adult Patients with Acute Myeloid Leukemia

The aim of this work is to investigate the different expression patterns of B cell-specifics moloney murine Leukemia virus integration site-1 (BMI-1) and brain and acute leukemia, cytoplasmic (BAALC) genes, their prognostic and clinical significance in newly diagnosed cytogenetically heterogenous adult acute myeloid leukemia patients. BMI-1 and BAALC expression was detected in the bone marrow of patients using quantitative real-time reverse transcription polymerase chain reaction with cut off value set at 50th percentile for both genes. BMI-1 and BAALC overexpression was detected in 50% of cases which suggest their potential as molecular markers. A statistical significant correlation was found between BMI-1 expression with hepatomegaly ( P value = 0.007), hemoglobin level-grouped ( P value = 0.047) and cytogenetic risk groups ( P value = 0.036). There was a statistically significant correlation between BAALC and age ( P value = 0.015), lymphadenopathy ( P value = 0.043), CD34 expression ( P value = 0.003) and near statistical significance with FAB sub-groups ( P value = 0.054). No statistical significance was noted for other hematological findings and response to treatment except for BAALC gene and treatment response ( P value = 0.014). No statistical significance in overall survival and disease free survival for both genes was found. Their prospective screening in combination with other molecular markers can help refine myeloid leukemia staging and prognosis toward optimizing therapeutic interventions.