Expression of SATB2 in Acute Myeloid Leukemia and Its Prognostic Significance

Background: Human special AT-rich sequence-binding protein-2 (SATB2) is a novel DNA binding protein, which is involved in regulating gene expression. Recent studies conducted to evaluate the clinical significance of SATB2 in multiple malignant carcinomas, and have yielded controversial results. The purpose of this study is to investigate the expression status of SATB2 and its prognostic significance in AML patients.

Methods: Total RNA was extracted from bone marrow or plasma of 87 patients with AML and 21 health volunteers. The expression of SATB2 was examined by Realtime quantitative PCR. The relationship of SATB2 expression and other clinicopathological charactors and its prognosis significance were statistically analyzed.

Results: The relative expression of SATB2 was significantly up-regulated in AML patients (median value 0.061, range: 0.007-0.328) in comparison to those of healthy volunteers (median value 0.033, range: 0.008-0.077; P < 0.001) , and SATB2 expression level was much lower in patients who had achieved CR (median value 0.005, range: 0.001-0.006;P < 0.001) compared with newly diagnosed AML patients(median value 0.010, range: 0.002-0.027;P < 0.001).Furthermore, the expression of SATB2 was markedly associated with gender(P =0.043), WBC count(P =0.001), platelet count (P =0.025), BM blast count (P = 0.007) and Complete Remission (P < 0.001). Patients with higher SATB2 expression had a relatively poor overall survival(OS) (P = 0.009) and short disease-free survival(DFS) (P < 0.001). Moreover, SATB2 expression was an independent prognostic factors for both OS (P = 0.001) and DFS (P = 0.006).

Conclusions: SATB2 was significantly up-regulated in AML patients in comparison to healthy donors. Patients who had achieved CR usually had a lower level of SATB 2 expression compared with newly diagnosed AML patients. The over-expression of SATB2 is associated with poor prognosis in AML patients, and was an independent prognostic factor for both OS and DFS.