Vol 50, No 2 (2019)
Original Research Article / Praca Oryginalna
Published online: 2019-08-23

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The role of neuronal apoptosis inhibitory protein (NAIP) in acute myeloid leukemia patients

Agnieszka Pluta1, Tadeusz Robak1, Kamil Brzozowski1, Barbara Cebula-Obrzut2, Agata Majchrzak2, Piotr Pluta3, Anna Szmigielska-Kapłon1, Olga Grzybowska-Izydorczyk2, Magdalena Czemerska1, Piotr Stelmach1, Piotr Smolewski2, Agnieszka Wierzbowska1
DOI: 10.2478/ahp-2019-0011
Acta Haematol Pol 2019;50(2):74-80.


Acute myeloid leukemia (AML) is a heterogeneous, highly malignant neoplasm. Apoptosis is a complex process executed by caspases and suppressed by the inhibitor of apoptosis (IAP) family. Neuronal apoptosis inhibitory protein (NAIP), IAP’s member, may play an exceptional role in the mechanisms of tumors’ resistance to chemotherapy. The aims of the study were to assess the expression of NAIP in leukemic blasts of AML patients using flow cytometry and to evaluate its influence on disease outcome. NAIP expression was found in 106 out of 108 patients. A higher complete response rate was associated with a low expression of NAIP, age < 60 yo, and white blood cell count < 20 G/L ( = 0.009, = 0.033, and = 0.076, respectively) in univariate analyses and a low NAIP expression and age < 60 yo ( = 0.025 and = 0.013, respectively) in multivariate analyses. Longer overall survival (OS) in the univariate analysis was influenced by a low NAIP expression, age < 60 yo, and intensive chemotherapy ( = 0.033, < 0.001, and < 0.001, respectively). In the intensively treated group, better OS was observed in patients with age < 60 yo, AML, and a low NAIP expression ( = 0.03, = 0.024, and = 0.07, respectively). In multivariate analysis, longer OS was associated with age < 60 yo ( = 0.009) and AML ( = 0.007). In conclusion, we suggest that NAIP might play an adverse role in response to chemotherapy.

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