Amr Mohamed Gawaly
Tanta University, Egypt
Title: BAX gene as a novel expressed tumor associated antigen in Acute Lymphoblastic Leukemia
Biography
Biography: Amr Mohamed Gawaly
Abstract
The response of Acute Lymphoblastic Leukemia (ALL) patients to cytotoxic drugs is markedly variable with unpredicted therapeutic outcome. Therefore, identification of new biomarkers is very crucial to envisage patient response to therapy. Among these possible biomarkers are BCL-2 family genes that are important determinants of chemotherapy-induced apoptosis. Bax gene is a pro-apoptotic gene, while Aven & Survivin are anti-apoptotic genes that their significance in diagnosis and prognosis of ALL remains a matter of controversy. Therefore, the aim of this study was to assess Bax, Aven and Survivin gene expression and its prognostic significance as regard overall survival (OS) and disease free survival (DFS) in ALL patients. Methods: amongst 57 patients diagnosed with de novo ALL, 32 patients were examined for Bax, Aven and Survivin expression, whereas, 25 patients were examined for Aven and Survivin expression. Patients were followed up for 15 months to evaluate survival. Results: Bax, Aven and Survivin gene expression were positive in 25%, 59.6% and 66.7% of ALL patients respectively. Cumulative overall survival for Bax +ve ALL patients was 25% which was significantly (p= 0.001) lower than that of Bax –ve (100%) ALL patients. The overall survival in patients with Survivin +ve, Aven +ve and –ve Bax was 100% that was statistically (p=0.019) higher than all other combination (66.7%). Moreover, disease free survival of the same group (14 patients) versus all other combination (18 patients) was statistically significant (P=0.011). Conclusions: whilst Bax expression in ALL patients was associated with bad prognosis, its absence showed improved survival, particularly in patients with Aven and Survivin concomitant expression. We showed that a single biomarker cannot reliably be used to predict response to therapy and it is likely that combination of biomarkers will be necessary to convey better prognostic criteria to ALL patients.
