Dissertation
Dissertation > Medicine, health > Oncology > Hematopoietic and lymphoid neoplasms > Leukemia > Acute leukemia

The Clinical Significance of the Expression and Prognosis of Id1, Id2in AML, ALL and MDS

Author LiShiLei
Tutor LinFengRu
School Hebei Medical University
Course Internal Medicine
Keywords Id1 Id2 acute leukemia myelodysplastic syndrome expression prognosis
CLC R733.71
Type Master's thesis
Year 2012
Downloads 24
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Objective:To investigate the expression of inhibitor of differentiation(Id1,Id2) in acute myelogenous leukemia(AML),acute lymphocyticleukemia(ALL) and myelodysplastic syndrome(MDS), and to research therelationship between the expression of Id1,Id2and the prognosis of AML,ALLand MDS. In the same time, we also investigate the expression of Id1, Id2inhealthy volunteers’ blood and bone marrow.Methods:1Objects: Leukemia cells from75untreated AML patients’ bone marrowsamples; Leukemia cells from37untreated ALL patients’ bone marrowsamples; Leukemia cells from17untreated MDS patients’ bone marrowsamples; Bone marrow samples from20AML patients in complete remission;Bone marrow samples from20ALL patients in complete remission; Bloodsamples from18healthy volunteers; Bone marrow samples from20healthyvolunteers(normal controls).2We use fluorescent quantitative reverse transcription polymerase chainreaction(RT-PCR) to investigate the expression of Id1and Id2in every groups,and to analyze the significance of the expression values.Results:1The expression of Id1in every group1.1The expression of Id1in untreated AML patients and completely remissiveAML patientsThere are75patients in untreated AML group,20patients in completeremissive AML group. We regard20healthy volunteers’ bone marrow asnormal controls. The level of Id1in untreated AML group is higher than thatin normal controls (P=0.000<0.05), the level of Id1in complete remissiveAML group is higher than that in normal controls (P=0.000<0.05).We compare the level of Id1between untreated AML group and remissive AMLgroup, but there is no statistical significance (P=0.179>0.05). The level of Id1in21M3untreated patients which in untreated AML patients group is higherthan that in6M3patients in remission which in remissive group(P=0.005<0.05). We compare the level of Id1between54untreated AMLpatients (except M3patients in75patients) and14remissive AML patients(except M3patients in20patients), there is no statistical significance(P=0.946>0.05).1.2The expression of Id1in untreated ALL patients and completely remissiveALL patientsThere are37patients in untreated ALL group,20patients in completelyremissive ALL group. We regard20healthy volunteers’ bone marrow asnormal controls. The level of Id1in untreated ALL group is higher than that innormal controls (P=0.000<0.05), the level of Id1in remissive ALL group ishigher than that in normal controls (P=0.000<0.05).We compare the level ofId1between untreated ALL group and remissive ALL group, but there is nostatistical significance (P=0.96>0.05).1.3The expression of Id1in bone marrow samples of untreated MDS patientsThere are17patients in untreated MDS group. We regard20healthyvolunteers’ bone marrow as normal controls. The level of Id1in untreatedMDS group is higher than that in normal controls (P=0.000<0.05).1.4The expression of Id1in blood samples of healthy volunteersThere are18patients in healthy volunteers,blood group. We regard20healthy volunteers’ bone marrow as normal controls. The level of Id1inhealthy volunteers’ blood group is lower than that in normal controls(P=0.018<0.05).1.5We separately divide untreated AML group, untreated ALL group anduntreated MDS group into three groups by sexual distinction、type andchromosome,and to investigate the expression of Id1in every groupIn untreated AML group, there are51male patients and24femalepatients. We compare the level of Id1between male and female groups, there is no statistical significance (P=0.288>0.05).There are16M2patients,21M3patients,10M4patients,27M5patients and1M7patient (the number is little,we do not put it in statistical analyze) in untreated AML patients, weseparately compare the level of Id1between them, but there is no statisticalsignificance (P=0.341>0.05). In untreated AML group, there are50patientshave chromosome examination. In the50patients, the number of chromosomepositive is29,chromosome negative is21. We compare the level of Id1between chromosome positive and negative, but there is no statisticalsignificance (P=0.165>0.05). In untreated ALL group, there are21malepatients and16female patients. We compare the level of Id1between maleand female groups, there is no statistical significance (P=0.453>0.05). Thereare27B-ALL patients,9T-ALL patients and1unclassified patient (thenumber is little, we do not put it in statistical analyze) in untreated ALLpatients, we compare the level of Id1between them, but there is no statisticalsignificance (P=0.213>0.05). In untreated ALL group, there are35patientshave chromosome examination. In the35patients, the number of chromosomepositive is27,chromosome negative is8. We compare the level of Id1betweenchromosome positive and negative, but there is no statistical significance(P=0.125>0.05). In untreated MDS group, there are5male patients and12female patients. We compare the level of Id1between male and female groups,there is no statistical significance (P=0.115>0.05). There are5MDS-RCMDpatients,11MDS-RAEB-2patients and1MDS-U patient (the number is little,we do not put it in statistical analyze) in untreated MDS patients, we comparethe level of Id1between them, but there is no statistical significance(P=0.632>0.05). In untreated MDS group, there are9patients havechromosome examination. In the9patients, the number of chromosomepositive is7,chromosome negative is2, the number are little, we do not putthem in statistical analyze.2The expression of Id2in every group2.1The expression of Id2in untreated AML patients and completely remissiveAML patients The level of Id2in untreated AML group is higher than that in normalcontrols (P=0.000<0.05), the level of Id2in completely remissive AML groupis higher than that in normal controls (P=0.000<0.05).We compare the level ofId2between untreated AML group and completely remissive AML group, butthere is no statistical significance (P=0.292>0.05). We compare the level ofId2between21M3untreated patients which in untreated AML patients groupand6M3patients in remission which in remissive group, but there is nostatistical significance (P=0.243>0.05). We compare the level of Id2between54untreated AML patients (except M3patients in75patients) and14remissive AML patients (except M3patients in20patients), there is nostatistical significance (P=0.671>0.05).2.2The expression of Id2in untreated ALL patients and completely remissiveALL patientsThe level of Id2in untreated ALL group is higher than that in normalcontrols (P=0.000<0.05), the level of Id2in completely remissive ALL groupis higher than that in normal controls (P=0.000<0.05).We compare the level ofId2between untreated ALL group and completely remissive ALL group, butthere is no statistical significance (P=0.731>0.05).2.3The expression of Id2in bone marrow samples of untreated MDS patientsThe level of Id2in untreated MDS group is higher than that in normalcontrols (P=0.016<0.05).2.4The expression of Id2in blood samples of healthy volunteersThe level of Id2in healthy volunteers’ blood group is higher than that innormal controls (P=0.033<0.05).2.5We separately divide untreated AML group, untreated ALL group anduntreated MDS group into three groups by sexual distinction、type andchromosome,and to investigate the expression of Id2in every groupIn untreated AML group, there are51male patients and24femalepatients. We compare the level of Id2between male and female groups, thereis no statistical significance (P=0.242>0.05).There are16M2patients,21M3patients,10M4patients,27M5patients and1M7patient (the number is little, we do not put it in statistical analyze) in untreated AML patients, weseparately compare the level of Id2between them, but there is no statisticalsignificance (P=0.121>0.05). In untreated AML group, there are50patientshave chromosome examination. In the50patients, the number of chromosomepositive is29,chromosome negative is21. We compare the level of Id2between chromosome positive and negative, but there is no statisticalsignificance (P=0.373>0.05). In untreated ALL group, there are21malepatients and16female patients. We compare the level of Id2between maleand female groups, there is no statistical significance (P=0.526>0.05). Thereare27B-ALL patients,9T-ALL patients and1unclassified patient (thenumber is little, we do not put it in statistical analyze) in untreated ALLpatients, we compare the level of Id2between them, but there is no statisticalsignificance (P=0.172>0.05). In untreated ALL group, there are35patientshave chromosome examination. In the35patients, the number of chromosomepositive is27,chromosome negative is8. We compare the level of Id2betweenchromosome positive and negative, but there is no statistical significance(P=0.338>0.05). In untreated MDS group, there are5male patients and12female patients. We compare the level of Id2between male and female groups,there is no statistical significance (P=0.509>0.05). There are5MDS-RCMDpatients,11MDS-RAEB-2patients and1MDS-U patient (the number is little,we do not put it in statistical analyze) in untreated MDS patients, we comparethe level of Id2between them, but there is no statistical significance(P=0.801>0.05). In untreated MDS group, there are9patients havechromosome examination. In the9patients, the number of chromosomepositive is7,chromosome negative is2, the number are little, we do not putthem in statistical analyze.Conclusions:1The expression level of Id1and Id2in untreated AML patients,untreated ALL patients and untreated MDS patients are higher than normalcontrols. Id1and Id2may be involved and play an important role to promoteproliferation and inhibit differentiation in the pathogenesis of AML, ALL and MDS.2The expression level of Id1in completely remissive AML patients andcompletely remissive ALL patients are higher than normal controls. There isno statistical significance to compare the expression level of Id1betweenuntreated ALL patients and completely remissive ALL patients. Theexpression level of Id1in remissive M3patients is lower than that in untreatedM3patients. There is no statistical significance to compare the level of Id1between remissive AML patients (except M3) and untreated AML patients(except M3). So we can make an conclusion that combined application ofretinoic acid and arsenic trioxide can reduce the level of Id1, in the meanwhile,we also conclude that the other commonly used chemotherapy drugs in thetreatment of acute leukemia can not make a change of Id1gene.3The expression level of Id2in completely remissive AML patients andcompletely remissive ALL patients are higher than normal controls. There isno statistical significance to compare the level of Id2between completelyremissive patients and untreated patients which in AML and ALL. There is nostatistical significance to compare the level of Id2between remissive M3patients and untreated M3patients. So we can conclude that the commonlyused chemotherapy drugs in the treatment of acute leukemia can not make achange of Id2gene.4The expression level of Id1in healthy volunteers’ blood is lower thanthat in healthy volunteers’ bone marrow, but the level of Id2is higher. So wecan conclude that Id1and Id2have different mechanism of action in theprocess of granulocytic maturation. The expression level of Id1and Id2aredifferent between blood and bone marrow.5Chemotherapy drugs can make different influence between Id1and Id2,at the same time, there are some differences of the expression level ofprimitive cell and mature cell between Id1and Id2, we guess that Id1and Id2have different regulation mechanism.6This study shows that the expression level of Id1and Id2have norelation with sexual distinction, type and chromosome. 7Maybe we can provide a theory about targeted therapy by study theregulation mechanism of Id1and Id2.

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