High CRLF2 Expression Could Identify Acute Lymphoblastic Leukemia Patients with Poor Outcome but Not IKZF1 | ||||
Research in Oncology | ||||
Article 4, Volume 17, Issue 1, June 2021, Page 23-30 PDF (279.97 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/resoncol.2020.39678.1111 | ||||
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Authors | ||||
Layla M. Saleh 1; Nour Darwish1; Sherin Abdel-Aziz1; Dalia Salem1; Noha Eisa2; Suzy Abd El Mabood3; Maryan W. Fahmi4; Ziad Emarah 4 | ||||
1Hematology Section, Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt | ||||
2Clinical Hematology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt | ||||
3Pediatric Hematology, Oncology and Bone Marrow Transplantation Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt | ||||
4Medical Oncology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt | ||||
Abstract | ||||
Background: Overexpression of cytokine receptor-like factor 2 (CRLF2) caused by different genetic aberrations has been observed in acute lymphoblastic leukemia (ALL) and correlated with poor outcome. Most patients with high CRLF2 expression are clustered in the Philadelphia-like (Ph-like) ALL subgroup. Ph-like ALL is reported to be associated with alterations in IKZF1 gene, encoding the transcription factor Ikaros. Aim: To identify CRLF2 and IKZF1 alterations in Egyptian patients with ALL and to determine their prognostic significance. Methods: Peripheral blood samples from 34 newly diagnosed ALL patients treated at an Egyptian tertiary oncology center and 14 controls were assessed for CRLF2 and IKZF1 mRNA expression using real-time polymerase chain reaction. Results: CRLF2 was significantly overexpressed in ALL patients compared to controls (p = 0.038). The response to treatment was significantly better in patients with low CRLF2 expression (p = 0.029). The rate of remission, relapse and induction death was 82%, 12% and 6% in the low CRLF2 expression group and 41%, 18% and 41% in the high expression one. Overall survival was significantly shorter among ALL with high CRLF2 (p = 0.034). IKZF1 expression level did not differ significantly between patients and controls. Patients with low IKZF1 exhibited significantly higher leucocytic count and lower platelet count (p = 0.038 and 0.044, respectively). IKZF1 overexpression did not correlate significantly with response to treatment or survival. Conclusion: High CRLF2 expression was associated with poor outcome among ALL patients. Further research is needed to improve the diagnostic and therapeutic approaches in ALL patients with poor prognosis. | ||||
Keywords | ||||
Acute lymphoblastic leukemia; Cytokine receptor-like factor 2; IKZF 1; qRT-PCR | ||||
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