The Prognostic Impact of Epidermal Growth Factor Receptor (EGFR) in Patients with Acute Myeloid Leukaemia
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The Prognostic Impact of Epidermal Growth Factor Receptor (EGFR) in Patients with Acute Myeloid Leukaemia Sukanta Nath1 • Jina Bhattacharyya2 • Partha Pratim Sarma1 • Renu Saxena3 Sudha Sazawal3 • Manash Pratim Barman4 • Kandarpa Kumar Saikia1
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Received: 30 October 2019 / Accepted: 17 March 2020 Ó Indian Society of Hematology and Blood Transfusion 2020
Abstract Expression of Epidermal Growth Factor Receptor (EGFR), an important proto-oncogene, regulates cell differentiation, proliferation, cell migration and survival in most of the cancer types. EGFR expression has been reported in Acute Myeloid Leukaemia (AML), however, many other reports nullified EGFR expression in AML. These contradictory data prompted us to reevaluate the expression of EGFR in AML and carry out a comparative survival analysis between EGFR expressing and non-expressing AML patients (Children and Acute Promyelocytic Leukaemia patients excluded). Bone marrow and/or peripheral blood samples were collected from 60 adult patients with AML with written informed consent. PCR, Real-Time Taqman gene expression assays were used for the detection of genetic alterations. Statistical analysis was conducted using SPSS software (IBM SPSS 20). In our study, EGFR expression was detected in 21 out of 60, in 35% (95% C.I. 23.45–48.48) AML patients. Overall survival was significantly shorter in patients with EGFR (p = \ 0.01), with an average survival of 18.57 months (95% C.I. 12.42–24.73 months) compared with Sukanta Nath and Jina Bhattacharyya have contributed equally to this work. & Kandarpa Kumar Saikia [email protected] 1
Department of Bioengineering and Technology, Gauhati University, Guwahati 781014, Assam, India
2
Department of Clinical Haematology, Gauhati Medical College and Hospital, Guwahati, India
3
Department of Haematology, All India Institute of Medical Sciences, New Delhi, India
4
Department of Statistics, Dibrugarh University, Dibrugarh, India
31.27 months (95% C.I. 28.19–34.33 months) in patients without EGFR. EGFR expression was significantly higher in female patients compared to male (p = 0.037).This study confirms the presence of EGFR in AML and indicates that EGFR expression confers poor prognosis in AML. However, the underlying cause of this adverse prognostic effect has not been identified. Further clinical studies are warranted to determine the exact mechanism through which EGFR activity might contribute to AML progression and identify the potential therapeutic target for the reversal of resistance to conventional chemotherapeutics. Keywords AML EGFR expression Real-time PCR Prognostic impact
Introduction Acute Myeloid Leukaemia (AML) is a genetically heterogeneous clonal disorder that results in disruption of selfrenewal, proliferation, and differentiation. Molecular and cytogenetic studies have reported a number of genetic alterations in AML such as Runt-related transcription factor 1/RUNX1 Partner Transcriptional Co-Repressor 1(RUNX1-RUNX1T1), Core-Binding Factor Beta/Myosin Heavy Chain 11 (
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