Quantitative assessment of BAX transcript and flow cytometric expression in acute myeloid leukemia: A prospective study

Figures & data

Figure 1. RQ PCR for assessment of the BAX transcripts in AML patients. (A) Amplification curves for 2 AML patients with the standard of known concentration and negative control. (B) Standard curve for the quantification of the BAX transcript.

Figure 2. Flow cytometry-based assessment of the BAX protein in AML patients. (A) Gating of the myeloblasts on the basis of the CD 45 expression. (B) BAX isotype control on the gated myeloblasts used to demarcate the negative selection. (C) BAX expression on the gated myeloblasts. (D) MFI of the BAX isotype control. (E) MFI of the BAX on the gated myeloblasts.

Table 1. Patients characteristics

Table 2. Expression of the BAX cytoplasmic protein (percentage and relative median fluorescence intensity RMFI by flow cytometry) and transcript (Q PCR)

Figure 3. (A) Correlation of the BAX percentage expression with the RMFI. (B) Correlation of the BAX transcripts expression with the protein expression.

Figure 4. Box plots (A) Comparison of the percentage BAX expression of the AML patients with control. (B) Comparison of the RMFI of the BAX of the AML patients with control. (C) Comparison of the BAX transcripts of the AML patients with control.

Table 3. Correlation of the BAX transcript expression with the baseline patient characteristics

Table 4. BAX expression (transcript level, more than or less than the median) with the remission and the outcome

Table 5. Studies of the BAX expression and their impact on the clinical outcome

Köhler T, Schill C, Deininger MW, Krahl R, Borchert S, Hasenclever D, et al. High Bad and Bax mRNA expression correlate with negative outcome in acute myeloid leukemia (AML). Leukemia 2002;16:22–9.

 PubMed Web of Science ®Google Scholar

Hess CJ, Berkhof J, Denkers F, Ossenkoppele GJ, Schouten JP, Oudejans JJ, et al. Activated intrinsic apoptosis pathway is a key related prognostic parameter in acute myeloid leukemia. J Clin Oncol. 2007;25:1209–15.

 PubMed Web of Science ®Google Scholar

Wuchter C, Karawajew L, Ruppert V, Buchner T, Schoch C, Haferlach T, et al. Clinical significance of CD95, Bcl-2 and Bax expression and CD95 function in adult de novo acute myeloid leukemia in context of P-glycoprotein function, maturation stage, and cytogenetics. Leukemia 1999;13:1943–53.

 PubMed Web of Science ®Google Scholar

Narayan S, Chandra J, Sharma M, Naithani R, Sharma S. Expression of apoptosis regulators Bcl-2 and Bax in childhood acute lymphoblastic leukemia. Hematology 2007;12:39–43.

 PubMed Web of Science ®Google Scholar

Nuessler V, Stötzer O, Gullis E, Pelka-Fleischer R, Pogrebniak A, Gieseler F, et al. Bcl-2, bax and bcl-xL expression in human sensitive and resistant leukemia cell lines. Leukemia 1999;13:1864–72.

 PubMed Web of Science ®Google Scholar

Katkoori VR, Suarez-Cuervo C, Shanmugam C, Jhala NC, Callens T, Messiaen L, et al. Bax expression is a candidate prognostic and predictive marker of colorectal cancer. J Gastrointest Oncol. 2010;1:76–89.

 PubMedGoogle Scholar

Kornblau SM, Vu HT, Ruvolo P, Estrov Z, O'Brien S, Cortes J, et al. BAX and PKCα modulate the prognostic impact of BCL2 expression in acute myelogenous leukemia. Clin Cancer Res. 2000;6:1401–9.

 PubMed Web of Science ®Google Scholar

Marx D, Binder C, Meden H, Lenthe T, Ziemek T, Hiddemann T, et al. Differential expression of apoptosis associated genes bax and bcl-2 in ovarian cancer. Anticancer Res. 1997;17:2233–40.

 PubMed Web of Science ®Google Scholar

Friess H, Lu Z, Graber HU, Zimmermann A, Adler G, Korc M, et al. Bax, but not Bcl-2, influences the prognosis of human pancreatic cancer. Gut 1998;43:414–21.

 PubMed Web of Science ®Google Scholar

Tai YT, Lee S, Niloff E, Weisman C, Strobel T, Cannistra SA. BAX protein expression and clinical outcome in epithelial ovarian cancer. J Clin Oncol. 1998;16:2583–90.

 PubMed Web of Science ®Google Scholar

Bairey O, Zimra Y, Shaklai M, Okon E, Rabizadeh E. Bcl-2, Bcl-X, Bax, and Bak expression in short- and long-lived patients with diffuse large B-cell lymphomas. Clin Cancer Res. 1999;5:2860–6.

 PubMed Web of Science ®Google Scholar

Giatromanolaki A, Sivridis E, Stathopoulos GP, Fountzilas G, Kalofonos HP, Tsamandas A, et al. Bax protein expression in colorectal cancer: association with p53, bcl-2 and patterns of relapse. Anticancer Res. 2001;21:253–9.

 PubMed Web of Science ®Google Scholar

Kymionis GD, Dimitrakakis CE, Konstadoulakis MM, Arzimanoglou I, Leandros E, Chalkiadakis G, et al. Can expression of apoptosis genes, bcl-2 and bax, predict survival and responsiveness to chemotherapy in node-negative breast cancer patients? J Surg Res. 2001;99:161–8.

 PubMed Web of Science ®Google Scholar

Gessner C, Liebers U, Kuhn H, Stiehl P, Witt C, Schauer J, et al. BAX and p16INK4A are independent positive prognostic markers for advanced tumour stage of nonsmall cell lung cancer. Eur Respir J. 2002;19:134–40.

 PubMed Web of Science ®Google Scholar

Hogarth LA, Hall AG. Increased BAX expression is associated with an increased risk of relapse in childhood acute lymphocytic leukemia. Blood 1999;93:2671–8.

 PubMed Web of Science ®Google Scholar

Ong YL, McMullin MF, Bailie KE, Lappin TR, Jones FG, Irvine AE. High bax expression is a good prognostic indicator in acute myeloid leukaemia. Brit J Haematol. 2000;111:182–9.

 PubMed Web of Science ®Google Scholar