Tzu-Hung HsiaoRen Ching WangTsai-Jung LuChien-Hung ShihYu-Chen SuJia-Rong TsaiPei-Pei JhanCai-Sian LiaHan-Ni ChuangKuang-Hsi ChangChieh-Lin Teng2026-01-302026-01-302021-04-0810.3389/fphar.2021.649267https://scholars.csmu.edu.tw/handle/123456789/4155<jats:p><jats:bold>Background:</jats:bold> Identifying patients with <jats:italic>de novo</jats:italic> acute myeloid leukemia (AML) who will probably respond to the “7 + 3” induction regimen remains an unsolved clinical challenge. This study aimed to identify whether c-Myc could facilitate cytogenetics to predict a “7 + 3” induction chemoresponse in <jats:italic>de novo</jats:italic> AML.</jats:p><jats:p><jats:bold>Methods:</jats:bold> We stratified 75 untreated patients (24 and 51 from prospective and retrospective cohorts, respectively) with <jats:italic>de novo</jats:italic> AML who completed “7 + 3” induction into groups with and without complete remission (CR). We then compared Myc-associated molecular signatures between the groups in the prospective cohort after gene set enrichment analysis. The expression of c-Myc protein was assessed by immunohistochemical staining. We defined high c-Myc-immunopositivity as &amp;gt; 40% of bone marrow myeloblasts being c-Myc (+).</jats:p><jats:p><jats:bold>Results:</jats:bold> Significantly more Myc gene expression was found in patients who did not achieve CR by “7 + 3” induction than those who did (2439.92 ± 1868.94 vs. 951.60 ± 780.68; <jats:italic>p</jats:italic> = 0.047). Expression of the Myc gene and c-Myc protein were positively correlated (r = 0.495; <jats:italic>p</jats:italic> = 0.014). Although the non-CR group did not express more c-Myc protein than the CR group (37.81 ± 25.13% vs. 29.04 ± 19.75%; <jats:italic>p</jats:italic> = 0.151), c-Myc-immunopositivity could be a surrogate to predict the “7 + 3” induction chemoresponse (specificity: 81.63%). More importantly, c-Myc-immunopositivity facilitated cytogenetics to predict a “7 + 3” induction chemoresponse by increasing specificity from 91.30 to 95.92%.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> The “7 + 3” induction remains the standard of care for <jats:italic>de novo</jats:italic> AML patients, especially for those without a high c-Myc-immunopositivity and high-risk cytogenetics. However, different regimens might be considered for patients with high c-Myc-immunopositivity or high-risk cytogenetics.</jats:p>journal-article