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Absence or low expression of fas-associated protein with death domain in acute myeloid leukemia cells predicts resistance to chemotherapy and poor outcome.

Abstract
In acute myeloid leukemia (AML), coexpression of death receptors and ligands of the tumor necrosis factor (TNF) receptor/TNF-alpha superfamily on leukemic cells after chemotherapy is not always accompanied by apoptosis, suggesting that the apoptotic death receptor signaling pathway is disrupted. Because Fas-associated protein with death domain (FADD) is the main adaptor for transmitting the Fas, TNF-related apoptosis-inducing ligand receptors, and TNF receptor 1 death signal, expression of FADD was analyzed by Western blot and immunocytochemistry in leukemic cells of 70 de novo AML patients treated with the European Organization of Research and Treatment of Cancer AML-10 randomized trial before initiation of induction chemotherapy. Thirty seven percent of patients (17 of 46) with FADD negative/low (FADD(-/low)) leukemic cells had a primary refractory disease compared with 12% of FADD(+) patients (3 of 24; P = 0.05). FADD(-/low) expression was significantly associated with a worse event-free survival [EFS (P = 0.04)] and overall survival (P = 0.04). In multivariate analysis, FADD(-/low) protein expression was independently associated with a poor EFS and overall survival (P = 0.002 and P = 0.026, respectively). Importantly, FADD(-/low) protein expression predicted poor EFS even in patients with standard- or good-risk AML (P = 0.009). Thus, we identified low or absent expression of the FADD protein in leukemic cells at diagnosis as a poor independent prognostic factor that can predict worse clinical outcome even for patients with standard- or good-risk AML.
AuthorsLéa Tourneur, Stéphanie Delluc, Vincent Lévy, Françoise Valensi, Isabelle Radford-Weiss, Ollivier Legrand, Jacques Vargaftig, Charlotte Boix, Elizabeth A Macintyre, Bruno Varet, Gilles Chiocchia, Agnès Buzyn
JournalCancer research (Cancer Res) Vol. 64 Issue 21 Pg. 8101-8 (Nov 01 2004) ISSN: 0008-5472 [Print] United States
PMID15520222 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Adaptor Proteins, Signal Transducing
  • FADD protein, human
  • Fas-Associated Death Domain Protein
  • fas Receptor
  • Caspases
Topics
  • Adaptor Proteins, Signal Transducing (analysis)
  • Adolescent
  • Adult
  • Blotting, Western
  • Caspases (physiology)
  • Cell Line, Tumor
  • Drug Resistance, Neoplasm
  • Fas-Associated Death Domain Protein
  • Humans
  • Immunohistochemistry
  • Leukemia, Myeloid, Acute (drug therapy, metabolism, mortality)
  • Microscopy, Confocal
  • Microscopy, Fluorescence
  • Middle Aged
  • Prognosis
  • fas Receptor (analysis)

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