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Objective PDZ and LIM domain 4 (PDLIM4) was reported as being reduced in various cancer cell lines and primary tumor cells.The alterations of PDLIM4 gene have rarely been studied in acute myeloid leukemia (AML).This study is aimed to investigate the expression pattern of PDLIM4 and its clinical relevance in AML patients.Methods EvaGreen real-time quantitative PCR (RQ-PCR) was performed to investigate the expression pattern of PDLIM4 and its clinical relevance in AML patients was analyzed.Results PDLIM4 transcript was significantly decreased in 94 AML patients compared with 21 controls (P<0.001).Decreased expression of PDLIM4 transcript was found in 42 (45%) AML patients.PDLIM4 underexpression occurred more frequently among the subtypes of M1/M2/M3 versus M4/M5/M6 (56% versus 20%,P=0.002).AML patients with PDLIM4 underexpression had favorable overall survival (OS) compared with those without PDLIM4 underexpression (P=0.019).Receiver operating characteristic (ROC) analysis reflected that PDLIM4 expression had diagnostic ability for discriminating AML from controls,with ROC curve areas of 0.865 (95 % CI:0.801-0.930).Conclusion These findings suggest that reduced PDLIM4 expression is a common event and has favorable impact on prognosis in AML and could be a potential diagnostic biomarker for cancer.