Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Clinical Pathology

Aim: The aim of this work is to investigate the expression pattern of B-cellspecifics moloney murine Leukemia virus integration site-1 (BMI-1) and brain and acute leukemia, cytoplasmic (BAALC) genes, their prognostic significance and their clinical significance in newly diagnosed Egyptian adult acute myeloid leukemia patients. Patients and Methods: The current study was carried out on 95 newly diagnosed adult (>18) acute myeloid leukemia patients, along with 20 age and sex matched apparently healthy normal controls. BMI-1 and BAALC expression was detected in the bone marrow of both patients and controls using quantitative real-time reverse transcription polymerase chain reaction (RT-PCR) with cut off value set at 50th percentile for both genes. Results: BMI-1 and BAALC expression was detected in 50% of cases but not in any controls. A statistical significant correlation was found between low BMI-1 expressers and hepatomegaly (p-value=0.007) while high BMI-1 expressers tend to have a lower hemoglobin level (<8) (p-value=0.081) and were more likely to be in the favorable cytogenetic risk group (P-value= 0.036). There was a statistically significant correlation between BAALC and age (P-value=0.015). The increase in BAALC expression was significantly associated with lymphadenopathy (p-value=0.043) and CD34 positive cases (p- value= 0.003). In addition, there was a trend of high BAALC expression to be associated with the more immature FAB subtypes (M1/M2) compared to the monocytic differentiated FAB (M4 and M5) (p-value {u2264}0.054). No statistical significance was noted for sex, splenomegaly, other hematological findings and response to treatment except for BAALC gene and response to treatment with a trend of higher death rate among low BAALC expressers and a higher incidence of CR among high BAALC expressers (P-value {u2264} 0.014). No statistical significance in overall survival and disease free survival for both genes was found

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