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Risk groups were used as a covariate for both univariate and multivariate models (Table?3). In separate univariate models, favourable-risk group was a strong predictor of improved OS (HR for death from study enrollment compared to intermediate-risk group: 0��31, P? http://www.selleckchem.com/products/abt-199.html predictor of decreased OS (HR?=?1��79, P?=?0��016) but not DFS (HR?=?1��48, P?=?0��142). In a multivariate model including high EVI1 expression and the aforementioned risk groups, EVI1high did not retain independent prognostic significance for OS (HR for death from study enrollment: 1��17, P?=?0��554). This retrospective study presents an evaluation of the biological associations and clinical relevance of diagnostic EVI1 expression in paediatric AML patients uniformly treated on the COG pilot trial AAML03P1. EVI1 expression levels varied broadly in our study, but only 28% of patients had overexpression of this gene (in excess of normal controls). Even within the cohort of EVI1high patients, a wide range of expression was noted, although the magnitude of this variation is probably amplified by the use of normal tissue, in which the gene is expressed at low levels, http://www.selleck.cn/products/CP-690550.html as a reference control. Nonetheless, by using overexpression above normal as a threshold for determining high EVI1 expression, we were able to detect intriguing biological differences between EVI1high patients and the remaining patients with http://www.selleckchem.com/products/ABT-263.html low or absent EVI1 expression. The prevalence of EVI1 overexpression in our study was higher than the 6�C10% reported in adult AML (Lugthart et?al, 2008; Gr?schel et?al, 2010); this age-dependent discrepancy is not surprising given the preponderance of MLL-rearranged infant patients in the EVI1Ihigh group. The prevalence of EVI1 overexpression in our study was also higher than the prevalence in the single prior paediatric report (Balgobind et?al, 2010), although this may reflect a difference in definition. EVI1 over-expression was reported on the basis of gene expression profiling in the Balgobind study, whereas our study defined EVI1high as over-expression relative to normal on the basis of qRT-PCR. The majority (81%) of EVI1high patients in our trial belonged to the intermediate-risk group based on current cytogenetic/molecular risk stratification; only two patients with either favourable-risk CBF chromosomal abnormalities, and/or favourable-risk gene mutations, exhibited overexpression of EVI1.