Prognostic impact of KMT2E transcript levels on outcome of patients with acute promyelocytic leukaemia treated with all-trans retinoic acid and anthracycline-based chemotherapy: An International Consortium on Acute Promyelocytic Leukaemia study Journal Article


Authors: Lucena-Araujo, A. R.; Kim, H. T.; Jacomo, R. H.; Melo, R. A.; Bittencourt, R.; Pasquini, R.; Pagnano, K.; Fagundes, E. M.; de Lourdes Chauffaille, M.; Chiattone, C. S.; Lima, A. S.; Kwaan, H. C.; Gallagher, R.; Niemeyer, C. M.; Schrier, S. L.; Tallman, M. S.; Grimwade, D.; Ganser, A.; Berliner, N.; Ribeiro, R. C.; Lo-Coco, F.; Löwenberg, B.; Sanz, M. A.; Rego, E. M.
Article Title: Prognostic impact of KMT2E transcript levels on outcome of patients with acute promyelocytic leukaemia treated with all-trans retinoic acid and anthracycline-based chemotherapy: An International Consortium on Acute Promyelocytic Leukaemia study
Abstract: The KMT2E (MLL5) gene encodes a histone methyltransferase implicated in the positive control of genes related to haematopoiesis. Its close relationship with retinoic acid-induced granulopoiesis suggests that the deregulated expression of KMT2E might lead acute promyelocytic leukaemia (APL) blasts to become less susceptible to the conventional treatment protocols. Here, we assessed the impact of KMT2E expression on the prognosis of 121 APL patients treated with ATRA and anthracycline-based chemotherapy. Univariate analysis showed that complete remission (P = 0·006), 2-year overall survival (OS) (P = 0·005) and 2-year disease-free survival (DFS) rates (P = 0·037) were significantly lower in patients with low KMT2E expression; additionally, the 2-year cumulative incidence of relapse was higher in patients with low KMT2E expression (P = 0·04). Multivariate analysis revealed that low KMT2E expression was independently associated with lower remission rate (odds ratio [OR]: 7·18, 95% confidence interval [CI]: 1·71-30·1; P = 0·007) and shorter OS (hazard ratio [HR]: 0·27, 95% CI: 0·08-0·87; P = 0·029). Evaluated as a continuous variable, KMT2E expression retained association with poor remission rate (OR: 10·3, 95% CI: 2·49-43·2; P = 0·001) and shorter survival (HR: 0·17, 95% IC: 0·05-0·53; P = 0·002), while the association with DFS was of marginal significance (HR: 1·01; 95% CI: 0·99-1·02; P = 0·06). In summary, low KMT2E expression may predict poor outcome in APL patients. © 2014 John Wiley & Sons Ltd.
Keywords: cancer chemotherapy; cancer survival; controlled study; survival rate; major clinical study; overall survival; drug efficacy; disease free survival; gene; gene expression; retrospective study; survival time; drug response; promyelocytic leukemia; remission; developing countries; anthracycline; retinoic acid; all-trans retinoic acid; cancer prognosis; human; male; female; priority journal; article; acute promyelocytic leukaemia; international consortium on acute promyelocytic leukaemia; kmt2e (mll5); kmt2e gene
Journal Title: British Journal of Haematology
Volume: 166
Issue: 4
ISSN: 0007-1048
Publisher: John Wiley & Sons  
Date Published: 2014-08-01
Start Page: 540
End Page: 549
Language: English
DOI: 10.1111/bjh.12921
PROVIDER: scopus
PUBMED: 24796963
DOI/URL:
Notes: Export Date: 2 September 2014 -- CODEN: BJHEA -- Source: Scopus
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  1. Martin Stuart Tallman
    649 Tallman