Prognostic impact of δ-like ligand 4 and Notch1 in acute myeloid leukemia

  • Authors:
    • Jingru Zhang
    • Daoxin Ma
    • Jingjing Ye
    • Shaolei Zang
    • Fei Lu
    • Meixiang Yang
    • Xun Qu
    • Xiulian Sun
    • Chunyan Ji
  • View Affiliations

  • Published online on: July 31, 2012     https://doi.org/10.3892/or.2012.1943
  • Pages: 1503-1511
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Abstract

Notch signaling plays a critical role in embryonic vascular development and tumor angiogenesis. The present study was conducted to investigate the prognostic role of the angiogenesis-related Notch ligand and the receptor in acute myeloid leukemia (AML) and assess whether their expression correlates with that of the vascular endothelial growth factor (VEGF) and angiopoietin (Ang)-2. Bone marrow mononuclear cells from 60 untreated AML patients and 40 healthy controls were obtained. Real-time RT-PCR was performed to evaluate the mRNA expression of δ-like ligand 4 (Dll4), Notch1, VEGF, VEGF receptor (VEGFR)-1, VEGFR-2, Ang-1, Ang-2 and Tie2. Western blot analysis was used to determine the protein levels of Dll4 and Notch1. The results demonstrated that Dll4, Notch1, VEGF, VEGFR-2 and Ang-2 expression were significantly higher in untreated AML patients than in the controls. Univariate analysis of factors associated with the overall survival showed a significantly shorter survival in patients with the unfavorable karyotype, higher Dll4 expression, higher Notch1 expression, higher VEGF expression or higher Ang-2 expression. Furthermore, multivariate analysis revealed that the karyotype and expression levels of Notch1, Dll4, VEGF and Ang-2 were independent prognostic factors for overall survival. Additionally, the prognostic value of Dll4 expression (but not Notch1) was more significant in the subgroup consisting of patients with intermediate-risk cytogenetics. Subgroup analysis showed that Notch1 and Dll4 expression levels had a prognostic impact on patients with high VEGF or Ang-2 levels. Taken together, our data provide evidence that the activation of the Notch pathway may indicate an unfavorable prognosis in AML. In particular, Dll4 may be a relevant prognostic marker in intermediate-risk AML.
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October 2012
Volume 28 Issue 4

Print ISSN: 1021-335X
Online ISSN:1791-2431

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Spandidos Publications style
Zhang J, Ma D, Ye J, Zang S, Lu F, Yang M, Qu X, Sun X and Ji C: Prognostic impact of δ-like ligand 4 and Notch1 in acute myeloid leukemia. Oncol Rep 28: 1503-1511, 2012.
APA
Zhang, J., Ma, D., Ye, J., Zang, S., Lu, F., Yang, M. ... Ji, C. (2012). Prognostic impact of δ-like ligand 4 and Notch1 in acute myeloid leukemia. Oncology Reports, 28, 1503-1511. https://doi.org/10.3892/or.2012.1943
MLA
Zhang, J., Ma, D., Ye, J., Zang, S., Lu, F., Yang, M., Qu, X., Sun, X., Ji, C."Prognostic impact of δ-like ligand 4 and Notch1 in acute myeloid leukemia". Oncology Reports 28.4 (2012): 1503-1511.
Chicago
Zhang, J., Ma, D., Ye, J., Zang, S., Lu, F., Yang, M., Qu, X., Sun, X., Ji, C."Prognostic impact of δ-like ligand 4 and Notch1 in acute myeloid leukemia". Oncology Reports 28, no. 4 (2012): 1503-1511. https://doi.org/10.3892/or.2012.1943