The Musashi 2 mRNA Expression in the Course of CML.
Authors: Nadvornikova Sylvie , Zackova Marketa , Lopotova Tereza , Klamova Hana , Moravcova Jana 
Published: October 2019

Abstract
Abstract 2552
The Musashi (MSI) gene family members, MSI1 and MSI2, represent an evolutionarily conserved family of RNA-binding proteins that regulate mRNA translation through binding in their N-termini. High levels of MSI2 protein are associated with increased cell proliferation, decreased cell maturation, more aggressive hematologic malignancy diseases and worse clinical prognosis. Recently obtained data pointed to MSI2 playing an important role in acute myeloid leukemia (AML) and in deadly blast crisis of chronic myeloid leukemia (CML) (Ito et al. 2010 Nature 5; 466).
In this study we screened the level of MSI2 mRNA in 49 patients in different phases of CML and with different response to therapy – 18 patients at diagnosis (DG), 5 in major molecular response (MMR), 4 in complete molecular response (CMR), 2 after bone marrow transplantation (BMT), 10 in hematology relaps (HR), 6 in accelerrated phase (AP), and 4 in blast crisis (BC), and in 6 healthy donors. The level of MSI2 mRNA was quantified by real-time reverse-transcriptase-polymerase chain reaction using in-house designed specific primers and TaqMan probe and normalized to B2M endogenous control. Expression ratios were calculated by ΔΔCt method, and the differences between groups were statistically evaluated using Mann Whitney test.
We detected MSI2 expression in all samples. The median expression of mRNA MSI2 in patients at DG was 1,43 (0,33–3,28), in MMR 0,52 (0,20–0,62), in CMR 0,37 (0,30–0,63), after BMT 1,28 (1,02–1,54), in HR 0,41 (0,16–0,58), in AP 3,78 (1,94–13,69), in BC 15,17 (2,61–28,15). MSI2 expression was statistically up-regulated in patients in advanced phases of CML (AP, BC) when compared with patients in CP (P<0.0001). The difference between patients in DG and remaining patients in CP was also statistically significant (P= 0,0006). No correlation of MSI2 expression level in DG patients with their responsiveness to treatment, BCR-ABL transcript level or survival was found. No significant differences were observed among groups of patients in MMR, CMR, HR, and after BMT.
In addition, in order to check whether MSI2 expression level can serve as a marker of CML progression we also retrospectively screened kinetics of MSI2 transcript in 5 CML patients monitored on average 27 months (18–48). During this period, 3 patients developed HR, 1 patient AP and 1 BC. In BC patient the MSI2 transcript level increased with progression of CML in accordance with the increase of leucocytes and BCR-ABL transcript level. In 1 patient with a rising AP BCR-ABL levels remained constant compared to sevenfold increase of the MSI2 transcript level. On the other hand in HR patients we detected a constant or even decreasing level of MSI2 transcript regardless of the increase of leucocytes and BCR-ABL.
In summary, our results confirm the association of high MSI2 mRNA level with advanced phases of CML and indicate that increase of MSI2 mRNA level may serve as a valuable marker of advanced phases of CML. In particular for CML patients with constantly high level of BCR-ABL mRNA the monitoring of MSI2 level can be important tool for early recognition of CML progression. Potential contributions of MSI2 to leukemic pathogenesis and its regulation in CML progression remain unknown.
Grant support: NT/12392-4 IGA MZ-CR.

Disclosures:
No relevant conflicts of interest to declare.