Role of Protein Bax and Bcl2 in The Prognosis of Acute Myeloid Leukemia in Adults

Abstract

Background: Acute myeloid leukaemia (AML) is a fatal hematological disease that occurs due to differentiation arrest and uncontrolled  proliferation of immature cells. Malignant cells undergo apoptosis when exposed to some anticancer medications; therapeutic resistance  may result from this resistance. In a variety of malignancies, Bax, Bcl2, and their ratio have all been identified as prognostic indicators.  Regarding AML, however, contradictory findings have been documented.

Objective: Our work investigated the association between Bax and Bcl-2 gene expression and their ratios with the therapeutic response in AML.

Patients and methods: Our prospective study included 55 newly diagnosed AML patients, treated at Hematology Department at Ain  Shams University Hospital during (January to December) 2023 and followed during the induction chemotherapy for 1 month.

Results: The  age of the patients participated in the study ranged from 18-60 years with a mean age of 40.84+/-12.74 years. Our patients were 26  (47.3%) males and 29 females (52.7%). ECOG score ranged from 1-5; one indicated restricted physical activity but ambulatory while five  referred to being dead. The cytogenetics of studied patients showed a major dominance for T (8-21) –ve and normal karyotyping of all the  participating patients. The study showed that Bax and Bcl-2 and their ratio expression in blood samples correlated with AML more  among poor responders and complicated patients during induction and there was statistically significant correlation between their level  and the outcome after chemotherapy.

Conclusion: Expression of Bax and Bcl2 and their ratio in AML patients differed significantly as  regard outcome after chemotherapy.