[The expression and clinical significance of survivin gene in leukemia].

OBJECTIVE: To investigate the expression of survivin in leukemia and the prognostic significance in acute leukemia (AL). METHODS: The expression of survivin mRNA was measured in 105 AL and 21 chronic myelogenous leukemia (CML) patients with semi-quantity reverse transcription (RT)-PCR. 15 adults were tested as normal control (NC) and K562, NB4, Kg-1alpha, HL-60 cell lines were also tested as positive control. The cell cycle distribution in AL was measured with flow cytometry (FCM) to analyze the relationship between the level of survivin and cell proliferation. RESULTS: The expression of survivin in de novo AL (0.525 +/- 0.460) was higher than that in NC (0.101 +/- 0.187), while it decreased in complete remission (CR) patients (0.280 +/- 0.095). In replased patients (0.935 +/- 0.343), the expression of survivin increased again. There was no difference of the expression between chronic phase of CML (0.279 +/- 0.112) and NC, but in acute phase of CML (0.653 +/- 0.236), the expression was higher than that in NC. The cases with higher level of survivin had significantly higher proliferation indices (mean PI 9.682) than those (mean PI 6.899). In AL patients, the CR rate of survivin positive cases was lower than that of survivin negative cases. CONCLUSIONS: The PI in survivin positive patients was significantly higher than that in survivin negative indicating its impact on proliferation and cleavage. Abnormal expression of survivin genes was related to pathogenesis and progression of AL and it can serve as a marker of relapse and poor prognosis in AL. Overexpression of survivin is a risk factor for CML.