Expression Pattern and Prognostic Significance of EVI1 Gene in Adult Acute Myeloid Leukemia Patients with Normal Karyotype

  • Irena Marjanovic
  • Teodora Karan-Djurasevic
  • Tatjana Kostic
  • Marijana Virijevic
  • Nada Suvajdzic-Vukovic
  • Sonja Pavlovic
  • Natasa TosicEmail author
Original Article


According to current criteria, patients with acute myeloid leukemia with normal karyotype (AML-NK) are classified as intermediate risk patients. There is a constant need for additional molecular markers that will help in substratification into more precise prognostic groups. One of the potential new markers is Ecotropic viral integration 1 site (EVI1) transcriptional factor, whose expression is dissregulated in abnormal hematopoietic process. The purpose of this study was to examine EVI1 gene expression in 104 adult AML-NK patients and on 10 healthy bone marrow donors using real-time polymerase chain reaction method, and to evaluate association between EVI1 expression level and other molecular and clinical features, and to examine its potential influence on the prognosis of the disease. Overexpression of EVI1 gene (EVI1+ status) was present in 17% of patients. Increased EVI1 expression was predominantly found in patients with lower WBC count (P = 0.003) and lower bone marrow blast percentage (P = 0.005). EVI1+ patients had lower WT1 expression level (P = 0.041), and were negative for FLT3-ITD and NPM1 mutations (P = 0.036 and P = 0.003). Patients with EVI1+ status had higher complete remission rate (P = 0.047), but EVI1 expression didn’t influence overall and disease free survival. EVI1 expression status alone, cannot be used as a new marker for more precise substratification of AML-NK patients. Further investigations conducted on larger number of patients may indicate how EVI1 expression could influence the prognosis and outcome of AML-NK patients, by itself, or in the context of other molecular and clinical parameters.


Acute myeloid leukemia Normal karyotype EVI1 expression Prognosis 



This work was funded by the Ministry of Education, Science and Technological Development, Republic of Serbia (Grant Number III 41004).

Author’s Contributions

IM, TKD and TK performed experimental work and analysis; MV and NSV contributed patients samples and data; SP designed the study and contributed to the finalization of the manuscript; NT conducted the statistical analysis, wrote the manuscript. All of the authors approved the submitted version.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accoedance with the ethical standards of Ethics Committee of the Clinical Center of Serbia and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Indian Society of Hematology and Blood Transfusion 2019

Authors and Affiliations

  1. 1.Laboratory for Molecular Biomedicine, Institute for Molecular Genetics and Genetic EngineeringUniversity of BelgradeBelgradeSerbia
  2. 2.Clinic of HematologyClinical Center of SerbiaBelgradeSerbia
  3. 3.School of MedicineUniversity of BelgradeBelgradeSerbia

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