Significance of PAX (CDX2) gene expression in adult acute Myeloid leukemia.

Background, CDX2, a gene of the paraHox cluster, encodes a homeodomain transcription factor that plays numerous roles in embryonic development. Its abnormal ectopic expression in acute leukemia is associated with a pro-oncogenic function. We aimed in this study to investigate CDX2 gene expression and its clinical significance in adult patients with acute myeloid leukemia. Methods, bone marrow and peripheral blood samples were collected from 70 newly diagnosed adult patients, the CDX2 gene expression in patients and normal controls (50 apparently normal persons) was detected by RT-PCR. The results, CDX2 gene expression was positive in 54 out of 70 AML patients (77.2%) however, no expression of CDX2 was observed in all control group. We did not find any significant difference between the two patients groups as regards the clinical manifestation, most of the laboratory parameters and response to induction therapy. Patients with positive CDX2 expression had significantly shorter relapse free survival (RFS) and overall survival (OS) (P=0.018 and 0.024 respectively). In conclusion, in spite of CDX2 gene expression does not significantly influence the response to induction therapy,it has a negative impact on the disease progression and survival rate in adult AML patients.