Clinical evaluation and proteomic profiles of acute myeloid leukemia patients, Saudi Arabia

Acute myeloid leukemia (AML) represents a group of clonal hematopoietic stem cell disorders which fail to differentiate and proliferate result in the accumulation of nonfunctional myeloblasts. In AML, response of patients to therapy is variables and there is no reliable marker to predict treatment response or prognosis of the disease. In this study, the main objective was to determine proteomic profiles of AML in patients referred to the King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. The AML patients were categorized according to risk degree based on the probability of survival. Clinical data were collected from 22 patients (16 males and 6 females) with consent. A clinical data form was developed to collect information on the diagnosis, prevention, and follow-up monitoring of AML patients. The clinical data showed that most patients (14) were cytogenetically and genetically normal and classified under the intermediate-risk category. Six patients expressed complex CCAAT/enhancer binding protein (CEBPA), FMS-related tyrosine kinase (FLT), isocitrate dehydrogenase (IDH) and Wilms tumor 1 (WT1) gene abnormalities, 2 patients showed inversion at chromosome 16 (inv.16) and 1 had t(15:17) chromosomal translocation. The high abundance protein in the samples must be depleted before subjecting to proteomic analyses. In the current study, the Pierce Albumin and IgG Removal, Albumin Depletion, and ProteoPrep® Immunoaffinity Albumin and IgG Depletion Kits were compared in the optimization of the samples. The Pierce Albumin and IgG Removal Kit was found to be the best depletion method for high abundance proteins. The protein expressions were compared among patients with different risk categories, at diagnosis and after remission. The AML samples from peripheral blood and bone marrow were analyzed by liquid chromatography tandem mass spectrometry (LCMS/MS). At diagnosis, in both the peripheral blood and bone marrow samples, 21 proteins were significantly (P