| Summary: | Xi-xi Li,1,2,* Jing-dong Zhou,1,3,4,* Xiang-mei Wen,3,5,* Ting-juan Zhang,1,3,4 De-hong Wu,6 Zhao-qun Deng,3,5 Zhi-hui Zhang,1,3,4 Xin-yue Lian,1,3,4 Pin-fang He,1,3,4 Xin-yu Yao,7 Jiang Lin,3,5 Jun Qian1,3,4 *These authors contributed equally to this work 1Department of Hematology, Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, People’s Republic of China; 2Department of Hematology, The Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu, People’s Republic of China; 3Zhenjiang Clinical Research Center of Hematology, Zhenjiang, Jiangsu, People’s Republic of China; 4The Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, Zhenjiang, Jiangsu, People’s Republic of China; 5Laboratory Center, Affiliated People’s Hospital of Jiangsu University, Zhenjiang, Jiangsu, People’s Republic of China; 6Department of Hematology, The Third People’s Hospital of KunShan City, 215300 Kunshan, People’s Republic of China; 7School of Medicine, Jiangsu University, Zhenjiang, Jiangsu, People’s Republic of ChinaBackground: Altered expression of the BCL-2 family member MCL-1 has been linked to the progression and outcome of various malignancies. Recently, MCL-1 inhibitor S63845 was reported to kill MCL-1-dependent cancer cells and has potential value in clinical application.Purpose: Herein, we reported MCL-1 expression pattern in Chinese de novo acute myeloid leukemia (AML) and its impact on prognosis and may provide theoretical basis for AML patients using MCL-1 inhibitor in clinics. Real-time quantitative PCR was carried out to detect the transcript of MCL-1 in AML patients.Results: MCL-1 expression was significantly up-regulated in AML compared with controls (P=0.042). We divided the patients into two groups (higher and lower expression of MCL-1) based on the median level. Among both non-acute promyelocytic leukemia (APL) and cytogenetically normal AML (CN-AML), patients with higher expression of MCL-1 correlated with lower complete remission (CR) rate (P=0.031 and 0.004, respectively) and shorter overall survival (OS) time (P=0.008 and 0.004, respectively) compared with those with lower expression of MCL-1. Meanwhile, Cox regression analyses revealed that overexpression of MCL-1 acted as an independent risk factor for OS in non-APL patients and CN-AML patients (P=0.011 and 0.045, respectively). In follow-up patients, MCL-1 expression level decreased after CR compared with newly diagnosis time (P=0.020) and increased after relapse (P=0.004).Conclusion: Our findings suggest that higher expression of MCL-1 predicts poor prognosis and can be used for disease monitoring.Keywords: MCL-1, expression, prognosis, recurrence, acute myeliod leukemia
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