MYC protein expression is an important prognostic factor in acute myeloid leukemia

Maro Ohanian, Uri Rozovski, Rashmi Kanagal-Shamanna, Lynne V. Abruzzo, Sanam Loghavi, Tapan Kadia, Andrew Futreal, Kapil Bhalla, Zhuang Zuo, Yang O. Huh, Sean M. Post, Peter Ruvolo, Guillermo Garcia-Manero, Michael Andreeff, Steven Kornblau, Gautam Borthakur, Peter Hu, L. Jeffrey Medeiros, Koichi Takahashi, Marisa J. HornbakerJianhua Zhang, Graciela M. Nogueras-González, Xuelin Huang, Srdan Verstovsek, Zeev Estrov, Sherry Pierce, Farhad Ravandi, Hagop M. Kantarjian, Carlos E. Bueso-Ramos, Jorge E. Cortes

Research output: Contribution to journalArticle

Abstract

As new drugs targeting MYC show clinical activity in acute myeloid leukemia (AML), understanding MYC expression in AML is of critical importance. We assessed MYC protein expression by immunohistochemistry in bone marrow of patients with untreated AML (n = 265). Overall, 90% of patients demonstrated MYC overexpression and MYC immunopositivity ≤6% was associated with superior complete remission (CR) duration of 23 months versus 12 months for MYC immunopositivity >6% (p =.028). Among 241 patients at higher risk for relapse, including those ≥55 years of age and patients with intermediate- and high-risk AML, MYC immunopositivity ≤6% conferred significantly superior median overall survival (OS) (24 versus 13 months; p =.042), event-free survival (EFS) (14 versus 6 months; p =.048), and relapse-free survival (RFS) (25 versus 12 months; p =.024). The prognostic impact of MYC-immunopositivity was retained on multivariate analysis of OS, EFS, and RFS. We conclude that MYC immunopositivity is an important prognostic factor in patients with untreated AML, particularly those at higher risk for relapse.

Original languageEnglish (US)
Pages (from-to)37-48
Number of pages12
JournalLeukemia and Lymphoma
Volume60
Issue number1
DOIs
StatePublished - Jan 2 2019
Externally publishedYes

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Acute Myeloid Leukemia
Recurrence
Survival
Proteins
Disease-Free Survival
Drug Delivery Systems
Multivariate Analysis
Bone Marrow
Immunohistochemistry

Keywords

  • Acute myeloid leukemia (AML)
  • immunohistochemistry (IHC)
  • MYC

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Ohanian, M., Rozovski, U., Kanagal-Shamanna, R., Abruzzo, L. V., Loghavi, S., Kadia, T., ... Cortes, J. E. (2019). MYC protein expression is an important prognostic factor in acute myeloid leukemia. Leukemia and Lymphoma, 60(1), 37-48. https://doi.org/10.1080/10428194.2018.1464158

MYC protein expression is an important prognostic factor in acute myeloid leukemia. / Ohanian, Maro; Rozovski, Uri; Kanagal-Shamanna, Rashmi; Abruzzo, Lynne V.; Loghavi, Sanam; Kadia, Tapan; Futreal, Andrew; Bhalla, Kapil; Zuo, Zhuang; Huh, Yang O.; Post, Sean M.; Ruvolo, Peter; Garcia-Manero, Guillermo; Andreeff, Michael; Kornblau, Steven; Borthakur, Gautam; Hu, Peter; Medeiros, L. Jeffrey; Takahashi, Koichi; Hornbaker, Marisa J.; Zhang, Jianhua; Nogueras-González, Graciela M.; Huang, Xuelin; Verstovsek, Srdan; Estrov, Zeev; Pierce, Sherry; Ravandi, Farhad; Kantarjian, Hagop M.; Bueso-Ramos, Carlos E.; Cortes, Jorge E.

In: Leukemia and Lymphoma, Vol. 60, No. 1, 02.01.2019, p. 37-48.

Research output: Contribution to journalArticle

Ohanian, M, Rozovski, U, Kanagal-Shamanna, R, Abruzzo, LV, Loghavi, S, Kadia, T, Futreal, A, Bhalla, K, Zuo, Z, Huh, YO, Post, SM, Ruvolo, P, Garcia-Manero, G, Andreeff, M, Kornblau, S, Borthakur, G, Hu, P, Medeiros, LJ, Takahashi, K, Hornbaker, MJ, Zhang, J, Nogueras-González, GM, Huang, X, Verstovsek, S, Estrov, Z, Pierce, S, Ravandi, F, Kantarjian, HM, Bueso-Ramos, CE & Cortes, JE 2019, 'MYC protein expression is an important prognostic factor in acute myeloid leukemia', Leukemia and Lymphoma, vol. 60, no. 1, pp. 37-48. https://doi.org/10.1080/10428194.2018.1464158
Ohanian M, Rozovski U, Kanagal-Shamanna R, Abruzzo LV, Loghavi S, Kadia T et al. MYC protein expression is an important prognostic factor in acute myeloid leukemia. Leukemia and Lymphoma. 2019 Jan 2;60(1):37-48. https://doi.org/10.1080/10428194.2018.1464158
Ohanian, Maro ; Rozovski, Uri ; Kanagal-Shamanna, Rashmi ; Abruzzo, Lynne V. ; Loghavi, Sanam ; Kadia, Tapan ; Futreal, Andrew ; Bhalla, Kapil ; Zuo, Zhuang ; Huh, Yang O. ; Post, Sean M. ; Ruvolo, Peter ; Garcia-Manero, Guillermo ; Andreeff, Michael ; Kornblau, Steven ; Borthakur, Gautam ; Hu, Peter ; Medeiros, L. Jeffrey ; Takahashi, Koichi ; Hornbaker, Marisa J. ; Zhang, Jianhua ; Nogueras-González, Graciela M. ; Huang, Xuelin ; Verstovsek, Srdan ; Estrov, Zeev ; Pierce, Sherry ; Ravandi, Farhad ; Kantarjian, Hagop M. ; Bueso-Ramos, Carlos E. ; Cortes, Jorge E. / MYC protein expression is an important prognostic factor in acute myeloid leukemia. In: Leukemia and Lymphoma. 2019 ; Vol. 60, No. 1. pp. 37-48.
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T1 - MYC protein expression is an important prognostic factor in acute myeloid leukemia

AU - Ohanian, Maro

AU - Rozovski, Uri

AU - Kanagal-Shamanna, Rashmi

AU - Abruzzo, Lynne V.

AU - Loghavi, Sanam

AU - Kadia, Tapan

AU - Futreal, Andrew

AU - Bhalla, Kapil

AU - Zuo, Zhuang

AU - Huh, Yang O.

AU - Post, Sean M.

AU - Ruvolo, Peter

AU - Garcia-Manero, Guillermo

AU - Andreeff, Michael

AU - Kornblau, Steven

AU - Borthakur, Gautam

AU - Hu, Peter

AU - Medeiros, L. Jeffrey

AU - Takahashi, Koichi

AU - Hornbaker, Marisa J.

AU - Zhang, Jianhua

AU - Nogueras-González, Graciela M.

AU - Huang, Xuelin

AU - Verstovsek, Srdan

AU - Estrov, Zeev

AU - Pierce, Sherry

AU - Ravandi, Farhad

AU - Kantarjian, Hagop M.

AU - Bueso-Ramos, Carlos E.

AU - Cortes, Jorge E.

PY - 2019/1/2

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N2 - As new drugs targeting MYC show clinical activity in acute myeloid leukemia (AML), understanding MYC expression in AML is of critical importance. We assessed MYC protein expression by immunohistochemistry in bone marrow of patients with untreated AML (n = 265). Overall, 90% of patients demonstrated MYC overexpression and MYC immunopositivity ≤6% was associated with superior complete remission (CR) duration of 23 months versus 12 months for MYC immunopositivity >6% (p =.028). Among 241 patients at higher risk for relapse, including those ≥55 years of age and patients with intermediate- and high-risk AML, MYC immunopositivity ≤6% conferred significantly superior median overall survival (OS) (24 versus 13 months; p =.042), event-free survival (EFS) (14 versus 6 months; p =.048), and relapse-free survival (RFS) (25 versus 12 months; p =.024). The prognostic impact of MYC-immunopositivity was retained on multivariate analysis of OS, EFS, and RFS. We conclude that MYC immunopositivity is an important prognostic factor in patients with untreated AML, particularly those at higher risk for relapse.

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