Hypoxia-inducible factor-1α protein expression is associated with poor survival in normal karyotype adult acute myeloid leukemia

We examined the predictive impact of HIF-1 alpha protein expression on clinical outcome of 84 normal karyotype acute myeloid leukemia (NK-AML) patients (median age 66.5 years) at our institute. Thirty percent of NK-AML cells expressed cytoplasmic HIF-1 alpha. In univariate analysis, low HIF-1 alpha (<= 5%, n = 66) was associated with improved event-free survival (p = 0.0453, HR = 0.22). Multivariate analysis incorporating age, complete remission, FLT3-ITD mutation, and marrow blast percentage demonstrated that HIF-1 alpha was independently associated with poorer overall and event-free survival. HIF-1 alpha expression correlated with VEGF-C but not VEGF-A, marrow angiogenesis, FLT3 ITD or NPM1 mutations. These results support HIF-1 alpha as an outcome marker for NK-AML. (C) 2010 Elsevier Ltd. All rights reserved.