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Blood, Vol. 94 No. 11 (December 1), 1999:
pp. 3717-3721
Cellular Vascular Endothelial Growth Factor Is a Predictor of
Outcome in Patients With Acute Myeloid Leukemia
Alvaro Aguayo,
Elihu Estey,
Hagop Kantarjian,
Taghi Mansouri,
Cristi Gidel,
Michael Keating,
Francis Giles,
Zeev Estrov,
Bart Barlogie, and
Maher Albitar
From the Departments of Leukemia and Laboratory Medicine, the
University of Texas MD Anderson Cancer Center, Houston, TX; and the
University of Arkansas for Medical Sciences, Little Rock, AR.
Vascular endothelial growth factor (VEGF) is a potent mitogen for
vascular endothelial cells. It has been associated with angiogenesis,
growth, dissemination, metastasis, and poor outcome in solid tumors. To
assess cellular VEGF levels and their prognostic significance in newly
diagnosed acute myeloid leukemia (AML), we used a radioimmunoassay
(RIA) to quantify VEGF levels in stored samples obtained before
treatment from 99 patients with newly diagnosed AML treated at the MD
Anderson Cancer Center from 1996 to 1998. Outcome in the 99 patients
was representative of that observed in all patients seen at this
institution with this diagnosis during these years, but the 99 patients
had higher white blood cell (WBC) and blast counts than the other
patients. Results of the RIA were confirmed by Western blot. There was
a relationship between increasing VEGF levels and shorter survival
(P = .01), as well as shorter disease-free survival, both
from start of treatment and from complete response (CR) date. In
contrast, there was no relationship between VEGF level and WBC or blast
count, or between VEGF level and such established prognostic factors as
age, cytogenetics, performance status, or presence of an antecedent
hematologic disorder, and multivariate analysis indicated that VEGF was
still prognostic for the above outcomes after accounting for these
factors, as well as treatment. Our results suggest that at least in AML
patients with higher WBC and blast counts, cellular VEGF level is an
independent predictor of outcome.
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