Prognostic Value of Fragile Histidine Triad Gene Expression in Egyptian patients with Acute Myeloid Leukemia

Background: AML is a relatively rare cancer, but is the most frequent form of acute leukemia. FHIT gene (Fragile Histidine Triad gene) is identified gene on chromosome 3p14.2 that has prognostic significance in AML. The aim of this work was to study the impact of FHIT gene expression on prognosis of AML in Egyptian patient. Patients and methods: This study was conducted on 50 Egyptian patients with newly diagnosed AML who were subjected to full history taking, clinical examination and laboratory investigations including: complete blood count, LDH, bone marrow aspiration, Cytochemistry, immunophenotyping and assessment of FHIT Gene by real time PCR in bone marrow aspirate mononuclear cells. Results: high gene expression was found in 26 cases (52%) and low expression in 24 cases (48%). High FHIT gene expression group includes 17 males (65.4%) and 9 females (34.6%) with mean age at presentation of 45.58 ±11.994 while low gene expression includes 12 males (50%) and 12 females (50%) with mean age at presentation of 39.17±12.967with no statistically significant differences between patients with high and low FHIT gene expression regarding age, sex and clinical presentations at time of diagnosis including pallor, splenomegaly, hepatomegaly and lymphadenopathy and laboratory investigations including WBCs and platelets counts, hemoglobin and LDH levels, and peripheral blood and bone marrow blast cell counts. There were statistically significant differences in disease outcome between high and low gene expression groups with higher rate of complete remission and Overall survival in high FHIT gene expression group compared with low FHIT gene expression group. Conclusion and Recommendation: FHIT expression is an important prognostic factor in AML patients with normal Karyotyped and therefore we recommend its incorporation into novel risk-adapted therapeutic strategies to improve the currently disappointing cure rate of patients with AML.