RUNX1 mutation and elevated FLT3 gene expression cooperates to induce inferior prognosis in cytogenetically normal acute myeloid leukemia patients

Abstract EN

Background: Acute myeloid leukemia (AML) is a bone marrow malignancy having multiple molecular pathways driving its progress.

In recent years, the main causes of AML considered all over the world are genetic variations in cancerous cells.

The RUNX1 and FLT3 genes are necessary for the normal hema-topoiesis and differentiation process of hematopoietic stem cells into mature blood cells, therefore they are the most common targets for point mutations resulting in AML.

Methods: We screened 32 CN-AML patients for FLT3-ITD (by Allele-specific PCR) and RUNX1 mutations (by Sanger sequencing).

The FLT3 mRNA expression was assessed in all AML patients and its subgroups.

Results: Eight patients (25%) carried RUNX1 mutation (K83E) while three patients (9.37%) were found to have internal tandem duplications in FLT3 gene.

The RUNX1 mutation data were correlated with clinical parameters and FLT3 gene expression profile.

The RUNX1 mutations were observed to be significantly prevalent in older males.

Moreover, RUNX1 and FLT3-mutated patients had lower complete remission rate, event-free survival rate, and lower overall survival rate than patients with wild-type RUNX1 and FLT3 gene.

The RUNX1 and FLT3 mutant patients with up-regulated FLT3 gene expression showed even worse prognosis.

Bradford Assay showed that protein concentration was down-regulated in RUNX1 and FLT3 mutants in comparison to RUNX1 and FLT3 wild-type groups.