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Subject Area

Anesthesiology and Intensive Care

Article Type

Original Study

Abstract

Objective To study diagnostic value of perforin-1 gene mRNA expression and its relation to patients' outcomes in acute myeloid leukemia (AML). Background AML is a molecularly heterogeneous hematological malignancy with variable response to treatment and characterized by bone marrow and tissue infiltration with abnormally differentiated cells of hematopoietic origin. Perforin-1 is a glycoprotein responsible for pore formation in cell membranes of target cells. It has a role in immune regulation. Without perforin-1, cytotoxic T cells and natural killer cells show reduced or no cytolytic effect on target cells. Patients and methods Expression levels of perforin-1 mRNA were assessed by reverse transcriptase PCR and correlated with patients' features of response and survival. Results Patients with AML had significantly lower perforin expression compared with the control group (P < 0.001). Only seven patients, representing 11.7% of the studied patients had low perforin expression which was significantly related to poor disease cytogenetics and poor response (P = 0.018 and 0.043, respectively). However, logistic regression analysis revealed that older age and poor cytogenetics were considered as independent risk predictors for poor response in studied AML cases. At the end of follow-up period, 55% of patients were alive. The relation between perforin expression and overall survival revealed that there was no significant relation between perforin expression and overall survival in the studied patients (P = 0.09). Conclusion Lower perforin-1 mRNA expression was significantly associated with some poor prognostic features in patients with AML, such as unfavorable cytogenetics and poor response. It is also associated with shorter survival; however, this relation was not statistically significant.

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