Long non-coding RNA ANRIL is a potential indicator of disease progression and poor prognosis in acute myeloid leukemia

The present study explored the association of long non-coding RNA (lncRNA) antisense non-coding RNA in the INK4 locus (ANRIL) with the development of acute myeloid leukemia (AML) clinical features and prognosis of patients with AML. Bone marrow mononuclear cells (BMMCs) were obtained from 178 patients with de novo AML prior to initial therapy and from 30 healthy donors. The expression of lncRNA ANRIL in BMMCs was detected by reverse transcription-quantitative PCR. Complete remission (CR) was assessed after induction therapy. Event-free survival (EFS) and overall survival (OS) were evaluated during the follow-up. The levels of lncRNA ANRIL were increased in patients with AML compared with those in healthy donors and were capable of distinguishing patients with AML from healthy donors (area under the curve, 0.886; 95% CI, 0.820-0.952). Furthermore, lncRNA ANRIL was associated with an increased occurrence internal tandem duplications in the FMS-like tyrosine kinase 3, decreased occurrence inv(16) or t(16;6), intermediate-risk and poor-risk stratification while no association of lncRNA ANRIL was identified with French-American-British classification, cytogenetics, isolated biallelic CCAAT/enhancer-binding protein alpha mutation and nucleophosmin 1 mutation in patients with AML. Furthermore, lncRNA ANRIL was significantly associated with a lower CR rate. In addition, EFS and OS were shorter in patients with high expression of lncRNA ANRIL compared with those in patients with low expression of lncRNA ANRIL. Multivariate Cox regression analyses revealed that high expression of lncRNA ANRIL, poor-risk stratification and white blood cells (>10.0x10(9) cells/l) were independent prognostic factors for shorter EFS, while high expression of lncRNA ANRIL and poorer risk stratification were independent prognostic factors for shorter OS. The present results suggested that lncRNA ANRIL has clinical relevance as a biomarker for assisting diagnosis treatment decisions and prognosis prediction and the identification of potential drug target for AML.