Association of Nucleophosmin-1 (NPM1) Expression with Leucocyte Count, Blast Count, and Gingiva Hypertrophy in Acute Myeloid Leukemia De Novo Patients in General Hospital of Dr M Djamil Padang Indonesia

Acute myeloid leukemia (AML) is a malignant disease derived from hematopoietic system characterized by neoplastic transformation of myeloid progenitor cell, present as excessive proliferation and differentiation alteration leading to inhibition of myeloid maturation. From various studies, incident and prevalence of AML these days is increasing in morbidity and mortality. This make AML known with poor prognosis. Nucleophosmin-1 (NPM-1) was established by WHO revision 2016 as prognostic gene marker in AML. Nucleophosmin-1 gene is mutated in 35-60% of AML cases. Recently, molecular biologic development suggests that prognostic gene examination is needed to reduce morbidity and mortality of AML patients. If myeloid progenitor cell encounters carcinogenic/leukemogenic stresses, mutation of several genes could happen. NPM1 gene is a likely mutated gene and predominantly located in nucleolus. Overexpression of NPM1 will promote activities of tumor suppressors like P53, ARF and MDM2. Interactions of those tumor suppressors promote proliferation, differentiation, cell survival, apoptosis and DNA repair, which give a better prognosis in AML patients.

To study about association of NPM1 expression with leucocyte count, blast count, and gingiva hypertrophy in AML de novo patients in general hospital of Dr M Djamil Padang, Indonesia.

Analytic observational study with cross-sectional approach to 25 adult AML patients from Policlinic and Inpatient Installation of Dr M Djamil Hospital from March to August 2018 who met inclusion and exclusion criteria. Expression of NPM1 was measured with qRT-PCR.

We found significant increase of NPM1 expression in AML in the amount of 22.62x10⁷ copies/ml. There was a significant very strong correlation between NPM1 expression and leucocyte count (p<0.05 & r=0.870) and blast count (p<0.05 & r=0.828). There was also significant differences of NPM1 expression in AML patients with gingival hypertrophy and without gingival hypertrophy (31.3 x 10⁷ copies/ml dan 9.6 x 10⁷ copies/ml).

There was a significant very strong correlation between NPM1 expression with leucocyte count and blast count. There was significant increases of NPM1 expression in AML patients with gingival hypertrophy.

Keywords: acute myeloid leukemia, Nucleophosmin-1, leucocyte, blast, gingival hypertrophy