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- Valérie Vidal, Guillaume Robert, Laure Goursaud, Laetitia Durand, Clemence Ginet, Jean Michel Karsenti, Frederic Luciano, Lauris Gastaud, Georges Garnier, Thorsten Braun, Pierre Hirsch, Emmanuel Raffoux, Anne Marie Nloga, Rose Ann Padua, Hervé Dombret, Pierre Rohrlich, Lionel Ades, Christine Chomienne, Patrick Auberger, Pierre Fenaux, and Thomas Cluzeau.
- INSERM U1131, Institut Universitaire d'hématologie, Paris, France.
- Oncotarget. 2017 Jul 18; 8 (29): 47103-47109.
AbstractAzacitidine (AZA), the reference treatment for most higher-risk myelodysplastic (MDS) patients can also improve overall survival (OS) in elderly acute myeloid leukemia (AML) patients ineligible for intensive chemotherapy, but reliable biological markers predicting response and OS in patients treated with AZA are lacking. In a preliminary study, we found that an increase of the percentage of BCL2L10, an anti-apoptotic member of the bcl-2 family, was correlated with AZA resistance. In this study, we assessed prospectively by flow cytometry the prognostic value of BCL2L10 positive bone marrow mononuclear cells in 70 patients (42 MDS and 28 AML), prior to AZA treatment.In patients with baseline marrow blasts below 30%, the baseline percentage of bone marrow BCL2L10 positive cells inversely correlated with response to AZA and OS independently of the International Prognostic Scoring System (IPSS) and IPSS-revised (IPSS-R). Specifically, OS was significantly lower in patients with more than 10% BCL2L10 positive cells (median 8.3 vs 22.9 months in patients with less than 10% positivity, p = 0,001). In summary, marrow BCL2L10 positive cells may be a biomarker for azacitidine response and OS, with a potential impact in clinical practice.
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