Significance of matrix metalloproteinase-9 evaluation in the bone marrow plasma from the patients with acute myeloid leukemia and myelodysplastic syndrome
I. F. Lesnichenko, Sergej V. Gritsaev, Ivan I. Kostroma
Russian Research Institute of Hematology and Transfusiology, St. Petersburg, Russia
The levels of matrix metalloproteinase-9 (MMP-9) were determined in bone marrow plasma (BMP) of eighty-seven patients, in order to assess clinical significance of this parameter. The study group involved thirty-nine patients with acute myeloid leukemia (AML), including 22 cases in complete remission (AML-CR), and 17 patients in active phase (AML-AP). Moreover, forty-eight patients with myelodysplastic syndrome (MDS) were observed, including 31 cases at high IPSS risk (MDS-HR with >5%<19% blasts in BM), and 17 cases with low IPSS risk (MDS-LR with<5% blasts in BM). Plasma MMP-9 concentrations were determined by means of a Human MMP-9 Immunoassay test kit (R&D Systems, USA). The mean level of MMP-9 in AML-CR was significantly higher than in AML-AP: 426,80±74,85 vs 73,20±51,43 ng/ml (p=0,0001). In MDS group, the mean level of MMP-9 was significantly higher in MDS-LR than in MDS-HR: 274,90±78,93 vs 120,10±38,72 ng/ml (p=0,021).When comparing different AML and MDS subgroups, it was shown that MMP-9 levels in MDS-LR and MDS-HR groups were significantly higher than in AML-AP (p=0,001). This finding was supposed to be associated with higher marrow blast counts in AML patients, than in MDS patients. At the same time, there were no significant differences between MMP-9 levels in MDS-LR and AML-CR (p=0,086). A dynamic MMP-9 monitoring has revealed that the MMP-9 levels in bone marrow plasma of three AML and two MDS patients who have achieved CR following chemotherapy, did increase, respectively, 5-15, and 6-17 times over the initial values. For relapsing patients, an opposite situation was revealed. The results obtained show that MMP-9 levels are associated with size of the malignant clone(s), and, therefore, they could be considered a promising marker for evaluation of treatment efficiency.
Myelodysplastic syndrome, remission, metalloproteinase 9, bone marrow, acute myeloid leukemia