Meningioma 1 (MN1) expression: Refined risk stratification in acute myeloid leukemia with normal cytogenetics (CN-AML)

Figures & data

Figure 1. Amplification plots of MN1 gene and GAPDH using real-time PCR. Real-time analysis of MN1 gene expression; the comparative CT method was used to determine the relative expression levels of MN1, and the cycle number difference (ΔCT = CT MN1 − CT GAPDH) was calculated for each sample. Relative MN1 expression values are expressed as 2 (ΔCT).

Table 1. AML patients characteristics according to MN1 expression status

	AML with high MN1 expression (n = 48)			AML with low MN1 expression (n = 52)
Variables	Mean ± SD range			Mean ± SD range			P
Age (year)	42.8 ± 12.9 (19–60)			39.1 ± 9.06 (19–59)			0.77
Sex, number
males	34 (40.9%)			22 (39.1%)			0.88
females	16 (59.1%)			28 (60.9%)
Pallor	20			15			0.27
Bleeding tendency	18			10			0.43
Splenomegaly	11			13			0.33
Hepatomegaly	19			15			0.46
Lymphoadenopathy	10			8			0.9
WBCs (10^9/l)	67.6 ± 65.8 (2.9–210.0)			44.4 ± 40.9 (3.7–137)			0.273
HB (g/dl)	8.1 ± 1.4 (6.2–11.3)			8.6 ± 2.1 (3.4–11.9)			0.142
Platelets (10^9/l)	90.8 ± 39.2 (13.3–150)			84.8± 47.6 (15.0–295)			0.351
PB blasts (%)	65.1 ± 22.3 (10.0–90.0)			50.1 ± 32.0 (15.0–85.0)			0.79
BM blasts (%)	75.0 ± 19.2 (35.0–100.0)			66.7 ± 23.1 (26.0–98.0)			0.22
FAB classification, number
M0	3		6.25%	6		11.5%	0.504
Ml	5		10.4%	11		21.1%
M2	9		18.7%	8		15.3%
M4	15		31.2%	10		19.2%
M5	10		20.8%	9		17.3%
M6	6		12.5%	8		15.3%

Table 2. Interrelation between NPM1 and FLT3-ITD mutations and MN1 expression

FLT3 and NPM1 mutational status	AML with high MN1 expression n = 48	AML with low MN1 expression n = 52
NPM1mut	15 (31.2%)	37 (71.2%)
NPM1wt	33 (68.8%)	15 (28.8%)
FLT3/ITD−	12 (25%)	41 (78.8%)
FLT3/ITD+	36 (75%)	11 (21.1%)
NPM1wt/FLT3-ITD−	7 (14.6%)	10 (19.2%)
NPM1wt/FLT3-ITD+	26 (54.2%)	5 (9.6%)
NPM1mut/FLT3-ITD+	10 (20.8%)	6 (11.5%)
NPM1mut/FLT3-ITD−	5 (10.4%)	31 (59.6%)

Table 3. Comparison between high and low expression of MN1 as regards to AML patients outcome

Outcome measures	High expression 48/100		Low expression 52/100		χ^Citation2	P
	n	%	n	%
Complete remission	30/48	62.5	46/52	88.4	13.23	0.001
Relapse	26/48	54.1	12/52	23	5.12	0.02
Refractory	18/48	37.5	10/52	19.2	15.70	<0.01
Total death	36/48	75	24/52	46.1	4.327	0.03

Figure 2. Kaplan–Meier curve for DFS in CN-AML patients according to MN1 expression.

Figure 3. Kaplan–Meier curve for OS in CN-AML patients according to MN1 expression.

Table 4. Odds ratio assessment in patients with higher MN1 expression as compared with those with lower expression

Parameters	Odds ratio high exp/low exp	95.0% CI for relative risk		P value
Total deaths	3.5	1.05	11.6	0.03
Complete remission	0.068	0.013	0.355	0.001
Relapse	3.93	1.16	13.28	0.02
Refractory	12.66	3.3	48.5	<0.01

Table 5. OS and DFS as dependent parameters studied with other covariates (multivariate analysis)

	Overall survival			Disease-free survival
	Hazard ratio	95% CI for relative risk	P value	Hazard ratio	95% CI for relative risk	P value
MN1 expression	2.176	(1.04–4.54)	0.03	2.33	(1.86–6.30)	0.04
Age	0.995	(0.962–1.029)	0.762	1.001	(0.959–1.04)	0.950
WBCs	0.998	(0.992–1.005)	0.576	1.000	(0.992–1.008)	0.976
Blast	1.010	(0.992–1.029)	0.274	0.996	(0.975–1.018)	0.748
FAB	0.972	(0.803–1.177)	0.773	0.992	(0.769–1.279)	0.949

Mrozek K, Heerema NA, Bloomfield CD. Cytogenetics in acute leukemia. Blood Rev. 2004;18:115–36.

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