Annals of Hematology

, Volume 92, Issue 4, pp 443–449 | Cite as

High expression of the Ets-related gene (ERG) is an independent prognostic marker for relapse-free survival in patients with acute promyelocytic leukemia

  • Anna Hecht
  • Daniel Nowak
  • Verena Nowak
  • Benjamin Hanfstein
  • Andreas Faldum
  • Thomas Büchner
  • Karsten Spiekermann
  • Cristina Sauerland
  • Eva Lengfelder
  • Wolf-Karsten Hofmann
  • Florian Nolte
Original Article

Abstract

In acute promyelocytic leukemia (APL), relapse occurs in about 15 % of cases and is a major cause for death. Molecular markers identifying patients at high risk for relapse are not well established. High expression of the transcription factor Ets-related gene (ERG) is associated with inferior overall survival (OS) and disease-free survival in different types of hematologic malignancies. There are no data available about the impact of ERG expression in APL. ERG expression levels were analyzed in bone marrow samples of 86 APL patients at initial diagnosis. High ERG expression was significantly associated with an inferior OS in patients who had reached first complete remission. It was also significantly correlated with inferior relapse-free survival (RFS) and time to relapse (i.e., relapse-free interval, RFI). In multivariate analysis, high ERG expression had an independent negative impact on RFS and RFI. High ERG expression was significantly associated with inferior OS, RFS, and RFI. Moreover, in multivariate analysis, it maintained its value as an independent negative prognostic factor with regard to RFS and RFI. Therefore, ERG expression might serve as a molecular marker for risk stratification in APL and might identify patients who could benefit from intensified treatment regimens.

Keywords

Acute promyelocytic leukemia ERG expression Prognosis Relapse Overall survival 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Anna Hecht
    • 1
  • Daniel Nowak
    • 1
  • Verena Nowak
    • 1
  • Benjamin Hanfstein
    • 1
  • Andreas Faldum
    • 2
  • Thomas Büchner
    • 3
  • Karsten Spiekermann
    • 4
  • Cristina Sauerland
    • 2
  • Eva Lengfelder
    • 1
  • Wolf-Karsten Hofmann
    • 1
  • Florian Nolte
    • 1
  1. 1.Department of Hematology and OncologyUniversity Hospital MannheimMannheimGermany
  2. 2.Institute of Biostatistics and Clinical ResearchUniversity of MünsterMünsterGermany
  3. 3.Department of Hematology/OncologyUniversity of MünsterMünsterGermany
  4. 4.Department of Hematology/OncologyUniversity of MunichMunichGermany

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