A renin-angiotensin system (RAS) exists locally within the bone marrow where it exerts an autocrine-paracrine effect on hematopoiesis. Its expression may be increased in some patients with acute myeloid leukemia (AML) and may contribute to leukemogenesis.


Methods of detecting increased expression of RAS:

(1) PCR for renin or angiotensinogen

(2) measurement of CD143 (angiotensin-converting enzyme) on the surface of blast cells (


Significance for patients with overexpresion of RAS:

(1) Increased RAS expression correlates with an elevated blast count and a worse prognosis.

(2) Remission is associated with disappearance of the overexpression.

(3) The excess in renin activity can result in a secondary hyperaldosteronism and a paraneoplastic hypokalemia.

(4) Inhibition of RAS components in theory could decrease blast proliferation.


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