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Prepublished online as a Blood First Edition Paper on May 15, 2003; DOI 10.1182/blood-2003-02-0359. This Article Full Text Full Text (PDF) All Versions of this Article: 2003-02-0359v1 102/5/1613    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Baldus, C. D. Articles by Bloomfield, C. D. Search for Related Content PubMed PubMed Citation Articles by Baldus, C. D. Articles by Bloomfield, C. D. Related Collections Neoplasia Gene Expression Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 September 2003, Vol. 102, No. 5, pp. 1613-1618 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS BAALC expression predicts clinical outcome of de novo acute myeloid leukemia patients with normal cytogenetics: a Cancer and Leukemia Group B Study Claudia D. Baldus, Stephan M. Tanner, Amy S. Ruppert, Susan P. Whitman, Kellie J. Archer, Guido Marcucci, Michael A. Caligiuri, Andrew J. Carroll, James W. Vardiman, Bayard L. Powell, Steven L. Allen, Joseph O. Moore, Richard A. Larson, Jonathan E. Kolitz, Albert de la Chapelle, and Clara D. Bloomfield From The Comprehensive Cancer Center, The Ohio State University, Columbus; The CALGB Statistical Center, Durham, NC; the University of Alabama at Birmingham; the University of Chicago, IL; the Wake Forest University School of Medicine, Winston-Salem, NC; the North Shore University Hospital, Manhasset, NY; and the Duke University School of Medicine, Durham, NC. Cytogenetic aberrations are important prognostic factors in acute myeloid leukemia (AML). Of adults with de novo AML, 45% lack cytogenetic abnormalities, and identification of predictive molecular markers might improve therapy. We studied the prognostic impact of BAALC (Brain And Acute Leukemia, Cytoplasmic), a novel gene involved in leukemia, in 86 de novo AML patients with normal cytogenetics who were uniformly treated on Cancer and Leukemia Group B 9621. BAALC expression was determined by comparative real-time reverse transcriptase–polymerase chain reaction in pretreatment blood samples, and patients were dichotomized at BAALC's median expression into low and high expressers. Low expressers had higher white counts (P = .03) and more frequent French-American-British M5 morphology (P = .007). Compared to low expressers, high BAALC expressers showed significantly inferior overall survival (OS; median, 1.7 vs 5.8 years, P = .02), event-free survival (EFS; median, 0.8 vs 4.9 years, P = .03), and disease-free survival (DFS; median, 1.4 vs 7.3 years, P = .03). Multivariable analysis confirmed high BAALC expression as an independent risk factor. For high BAALC expressers the hazard ratio of an event for OS, EFS, and DFS was respectively 2.7, 2.6, and 2.2. We conclude that high BAALC expression predicts an adverse prognosis and may define an important risk factor in AML with normal cytogenetics. 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