Analysis of thrombopoietin receptor (c-mpl) mRNA expression in de novo acute myeloid leukemia.

Expression of the thrombopoietin receptor, c-mpl, has been recently suggested to represent an adverse prognostic factor in myelodysplasia and acute myeloid leukemia (AML). To further evaluate this putative correlation, we assessed the c-mpl mRNA expression in blast samples of 53 AML patients. Overall, c-mpl mRNA expression was observed in 27 (51%) patients. No significant difference between c-mpl(+) and c-mpl(-) patients was found with respect to established prognostic factors such as age (50 vs. 53 years) or karyotype, whereas a significant correlation was observed between c-mpl and CD34 expression (P = 0.026). Among 40 patients who completed standard-/high-dose cytarabine-containing induction/consolidation treatment and were evaluable for treatment response, a higher complete remission (CR) rate was achieved in c-mpl- than in c-mpl(+) patients (95 vs. 68%; P = 0.026). Upon multivariate analysis, this relationship was independent from CD34 expression. CR duration was not significantly longer in c-mpl(-) than in c-mpl(+) patients (median: 14 vs. 10 months, P = 0.262). In conclusion, our data strongly support the previously suggested notion that c-mpl expression is of prognostic relevance for CR induction in de novo AML patients, and suggest determination of c-mpl expression within larger prospective studies in the attempt to develop risk-adapted AML treatment strategies.