Variability in expression of homeobox genes (HOXA9) and (HOXA7) in acute myeloid leukemia patients

The strong association between NPM1 mutation and increased expression levels of HOXA7 and HOXA9 implies that HOXA genes may be utilized as targeted treatment markers in NPM1-mutated patients. We examined HOXA7 and HOXA9 gene expression in acute myeloid leukemia (AML) patients with nucleophosmin1 (NPM1) mutation. This study included 91 cases of AML and 23 samples of matched healthy controls. HOXA7 and HOXA9 gene expression was analyzed using real-time PCR with SYBR Green dye. All cases were subjected to NPM1 mutation detection. Both HOXA7 and HOXA9 gene expressions were significantly correlated with age, with adult patients exhibiting substantially higher gene expression than pediatric patients (p < 0.01). Both HOXA7 and HOXA9 high gene expressions were significantly associated with NPM1 mutation (p = 0.032 and p = 0.001, respectively). Adult patients with AML demonstrated a higher level of HOXA9 expression, which has a negative impact on the disease-free survival of NPM1-mutated patients (p = 0.055). Therefore, targeting the HOXA9 pathway presents a highly plausible treatment option for NPM1-mutated adult AML patients.