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Title: BCL2 Expression at Post-Induction and Complete Remission Impact Outcome in Acute Myeloid Leukemia
Authors: Bilbao Sieyro, Cristina 
Rodríguez-Medina, Carlos
Florido, Yanira
Stuckey, Ruth
Sáez, María Nieves
Sánchez Sosa, José Santiago 
González Martín, Jesús María
Santana, Guillermo
González-Pérez, Elena
Cruz-Cruz, Naylén
Fernández, Rosa
Molero Labarta, María Teresa 
Gómez Casares, María Teresa 
UNESCO Clasification: 32 Ciencias médicas
320101 Oncología
Keywords: Acute myeloid leukemia
BCL2 inhibitors
Patient outcome
Induction therapy, et al
Issue Date: 2020
Journal: Diagnostics 
Abstract: Advances in acute myeloid leukemia (AML) genomics and targeted therapies include the recently approved BCL2 inhibitor venetoclax. The association between BCL2 expression and patient outcome was analyzed in a series of 176 consecutive AML patients at diagnosis (Dx), post-induction (PI), complete remission (CR) and relapse (RL). Levels increased significantly at relapse (mean 1.07 PI/0.96 CR vs. 2.17 RL, p = 0.05/p = 0.03). In multivariate analysis, high BCL2-Dx were marginally associated with worse progression-free survival, while high PI levels or at CR had an independent negative impact on outcome (PI: HR 1.58, p = 0.014; CR: HR 1.96, p = 0.008). This behavior of high PI or CR BCL2 levels and increased risk was maintained in a homogeneous patient subgroup of age <70 and intermediate cytogenetic risk (PI: HR 2.44, p = 0.037; CR: HR 2.71, p = 0.049). Finally, for this subgroup, high BCL2 at relapse indicated worse overall survival (OS, HR 1.15, p = 0.05). In conclusion, high BCL2 levels PI or at CR had an independent negative impact on patient outcome. Therefore, BCL2 expression is a dynamic marker that may be useful during AML patient follow up, and BCL2 levels at PI and/or CR may influence response to anti-BCL2 therapy.
ISSN: 2075-4418
DOI: 10.3390/diagnostics10121048
Source: Diagnostic [ ISSN 2075-4418], v. 10 (12), (Diciembre 2020)
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