Cellular vascular endothelial growth factor is a predictor of outcome in patients with acute myeloid leukemia

Vascular endothelial growth factor (VEGF) is a potent mitogen for vascular endothelial cells. It has been associated with angiogenesis, growth, dissem ination, metastasis, and poor outcome in solid tumors. To assess cellular V EGF levels and their prognostic significance in newly diagnosed acute myelo id leukemia (AML). we used a radioimmunoassay (RIA) to quantify VEGF levels in stored samples obtained before treatment from 99 patients with newly di agnosed AML treated at the MD Anderson Cancer Center from 1996 to 1998. Out come in the 99 patients was representative of that observed in all patients seen at this institution with this diagnosis during these years, but the 9 9 patients had higher white blood cell (WBC) and blast counts than the othe r patients. Results of the RIA were confirmed by Western blot. There was a relationship between increasing VEGF levels and shorter survival (P = .01). as well as shorter disease-free survival, both from start of treatment and from complete response (CR) date. In contrast, there was no relationship b etween VEGF level and WBC or blast count, or between VEGF lever and such es tablished prognostic factors as age, cytogenetics, performance status, or p resence of an antecedent hematologic disorder, and multivariate analysis in dicated that VEGF was still prognostic for the above outcomes after account ing for these factors, as well as treatment. Our results suggest that at le ast in AML patients with higher WBC and blast counts, cellular VEGF level i s an independent predictor of outcome. (C) 1999 by The American Society of Hematology.