Myeloid Cell Leukemia-1 Gene Expression and Clinicopathological Features in Myelodysplastic Syndrome

Background and Aims: Myeloid cell leukemia-1 (Mcl-1) plays a pivotal role in the survival of hematologic and solid tumors, and is known as a substantial oncogene. Studies have demonstrated the altered expression of Mcl-1 has been linked to malignancy development and poor prognosis. In this research, we have studied the expression of Mcl-1 mRNA in myelodysplastic syndrome (MDS) patients and determined association with clinico-pathological factors, MDS subgroups as well as international prognostic scoring system. Materials and Methods: The relative level of Mcl-1 was determined by real time quantitative real-time polymerase chain reaction and gene expression normalized to Glyceraldehyde-3-phosphate dehydrogenase. Results: Results indicated amplification of mRNA encoding Mcl-1 in 100% of the cases. The higher level of Mcl-1 existed in MDS patients compared with the healthy controls but there was no statistically difference of Mcl-1 expression between these groups. Fold change in gene expression was higher in advanced stage MDS, high risk MDS, cases with >5% blast and LDH >400 to their corresponding groups. In addition, the correlation between gene expression and cytogenetic prognostic subgroups was statistically significant (p=0.043). Conclusions: In the present study, we showed that Mcl-1 is expressed in MDS independent of the World Health Organization subgroup and international prognostic scoring system. Therefore, Mcl-1 may be up-regulated already in early stages of leukemogenesis.