Acute Myeloid Leukemia - New Study Reveals Method For Predicting Patient Prognosis

A recent study of leukemic stem cells (LSC) has concluded that individuals with acute myeloid leukemia who experienced more activity of particular LSC genes had more generally worse overall survival. The findings were published in the December 22 to 29 edition of the Journal of American Medical (JAMA).

Dr. Andrew J. Gentles, of Stanford University, Palo Alto, California, and fellow research members measured gene activity in LSC concentrated sub-groups of acute myeloid leukemia (AML) and regular control samples. The samples were conducted between April 2005 and July 2007.

“In many cancers, specific subpopulations of cells appear to be uniquely capable of initiating and maintaining tumors. The strongest support for this cancer stem cell model comes from transplantation assays in immunodeficient mice, which indicate that human acute myeloid leukemia (AML) is driven by self-renewing leukemic stem cells,” according to background information in the article. “A major implication of this cancer stem cell model is that the LSCs must be eliminated to eradicate the cancer and cure the patient. While AML was the first human malignancy for which this model gained experimental support, its clinical significance has yet to be fully established.”

The study revealed that concentrations of 52 genes separated LSC-laden populations from other sub-groups in cell-grouped AML samples. High LSC scores were correlated with relapse free survival in persons whose karyotypes were normal.

“In this study, we show that a gene expression score associated with the LSC-enriched subpopulation is an independent prognostic factor in AML, with high LSC score associated with adverse outcomes in multiple independent cohorts. If prospectively validated, the described LSC score may be incorporated into routine clinical practice for predicting prognosis in patients with AML and used in clinical trials incorporating risk-based stratification or randomization strategies.”

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