Expression of p53 and bcl-2 proteins in acute leukemias: an immunocytochemical study

We have analyzed by immunocytochemistry the p53 and Bcl-2 proteins expression in 49 patients with B-ALL, T-ALL and AML at the time of initial diagnosis. The diagnosis was based on morphologic and cytochemical criteria and on immunophenotyping. To demonstrate the p53 protein expression, p53 specific mouse antihuman immunoreagent clone DO-1 that recognizes both wild and mutated p53 protein was used. To detect Bcl-2 a monoclonal antibody that recognizes the 26-kD Bcl-2 protein was applied. For evaluation of both proteins a sensitive Immunotech detection kit based on peroxidase labeled streptavidin biotin reagent was utilized. The patients were divided according to the presence or absence of both, nuclear p53 and cytoplasmic Bcl-2 proteins. A relative low frequency of p53 protein expression in B- and T-lineage acute lymphoblastic leukemia has been shown at diagnosis. In AML cases, the frequency of p53 expression was higher than that in ALL. Bcl-2 protein immunoreactivity has been found in the majority of acute leukemia patients. The marked heterogeneity in the percentage of p53 and Bcl-2 positive cells in individual patients was observed. Comparative analysis of the distinct acute leukemia subtypes according to the percentage of p53 and Bcl-2 positive cells showed no significant differences except for p53 protein positivity in relation between T-ALL and AML cases. The samples from healthy subjects used as a control exhibited very low proportion of positively stained cells and significantly differed from p53 as well as Bcl-2 positive cases. p53 and Bcl-2 positivity have not been significantly affected neither by age, sex nor WB C counts. Association between myeloid cells maturation and proportion of p53 and Bcl-2 positive cells was observed. Noteworthy was the inverse relation between the higher proportion of p53 positive cells and low Bcl-2 positivity in some cases of acute leukemia. Although our preliminary results need to be confirmed in a larger group of patients, immunocytochemical analysis of p53 and Bcl-2 proteins, indicators of cell alterations, may help to identify risk patients requiring intensive therapy.