<p>Increased <em>MCL-1</em> expression predicts poor prognosis and disease recurrence in acute myeloid leukemia</p>

Abstract

<b>Background: </b>Altered expression of the <i>BCL-2</i> family member <i>MCL-1</i> has been linked to the progression and outcome of various malignancies. Recently, <i>MCL-1</i> inhibitor S63845 was reported to kill <i>MCL-1</i>-dependent cancer cells and has potential value in clinical application. <b>Purpose:</b> Herein, we reported <i>MCL-1</i> expression pattern in Chinese <i>de novo</i> acute myeloid leukemia (AML) and its impact on prognosis and may provide theoretical basis for AML patients using <i>MCL-1</i> inhibitor in clinics. Real-time quantitative PCR was carried out to detect the transcript of <i>MCL-1</i> in AML patients. <b>Results:</b> <i>MCL-1</i> expression was significantly up-regulated in AML compared with controls (<i>P</i>=0.042). We divided the patients into two groups (higher and lower expression of <i>MCL-1</i>) based on the median level. Among both non-acute promyelocytic leukemia (APL) and cytogenetically normal AML (CN-AML), patients with higher expression of <i>MCL-1</i> correlated with lower complete remission (CR) rate (<i>P</i>=0.031 and 0.004, respectively) and shorter overall survival (OS) time (<i>P</i>=0.008 and 0.004, respectively) compared with those with lower expression of <i>MCL-1</i>. Meanwhile, Cox regression analyses revealed that overexpression of <i>MCL-1</i> acted as an independent risk factor for OS in non-APL patients and CN-AML patients (<i>P</i>=0.011 and 0.045, respectively). In follow-up patients, <i>MCL-1</i> expression level decreased after CR compared with newly diagnosis time (<i>P</i>=0.020) and increased after relapse (<i>P</i>=0.004). <b>Conclusion:</b> Our findings suggest that higher expression of <i>MCL-1</i> predicts poor prognosis and can be used for disease monitoring.