We studied the expression of SPINK2 by IHC in 172 non-M3 adult AML patients...receiving Daunorubicin + Ara-C (DA 7+3) induction. Of these, SPINK2hi patients had lower CR rates (68.6% vs 90.0%,P=0.013), higher 6-month relapse rates (31.4% vs 6.9%,P=0.018), lower 5-yr RFS(27.0% vs 44.6%,P=0.018), EFS(15.4% vs 38.3%,P<0.001) and OS(22.9% vs 51.5%,P=0.002). High SPINK2 protein expression by IHC predicted increased chemoresistance and early relapse risk in AML...