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Identification of a gene expression signature associated with prognosis of pediatric

Most patients with acute myeloid leukemia (AML) enter complete remission (CR) after treatment with chemotherapy, but a large number of them relapse with resistant disease. To identify genes that are associated with their prognosis, we analyzed the gene expression of 54 pediatric patients with AML using an oligonucleotide microarray that contains 12,566 probe sets. A supervised approach using the Student's t-test selected a prognostic set of 35 genes, some of which are associated with regulation of cell cycle and apoptosis. Most of these genes had not previously been reported to be associated with prognosis, and were not correlated with morphologically classified French-American-British (FAB) subtypes or with karyotypes. These results indicate the existence of prognosis-associated genes, which are independent of cell lineage and cytogenetic abnormalities, and can provide therapeutic direction for individual risk-adapted therapy for pediatric AML patients.