Low ERG and BAALC expression identifies a new subgroup of adult acute T-Lymphoblastic leukemia with a highly favorable outcome
Low ERG and BAALC expression identifies a new subgroup of adult acute T-Lymphoblastic leukemia with a highly favorable outcome
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DOI：
10.1200/jco.2007.11.5253
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发表时间：
2007-08-20
影响因子：
45.3
通讯作者：
Hofmann, Wolf K.
中科院分区：
文献类型：
--
作者：
Baldus, Claudia D.;Martus, Peter;Hofmann, Wolf K.
目的ERG （v-ets红母细胞病病毒E26癌基因同源物）和BAALC（脑和急性白血病，细胞质）基因在造血成熟过程中的表达具有相似性，并可预测急性髓系白血病的预后。我们假设，与ERG一样，BAALC表达可能在急性t淋巴细胞白血病（T-ALL）中具有预后意义，并且ERG和BAALC表达一起可以更好地识别患者的风险状况。方法采用实时逆转录聚合酶链反应法检测153例T-ALL成人血清serg和BAALC mRNA的表达。患者被指定为低或高ERG表达者和低或高BAALC表达者。结果高BAALC表达与早期T-ALL （P < 0.0001）、CD34阳性（P < 0.0001）、髓系标志物共表达（P = 0.0001）和高ERG表达（P = 0.03）相关。与低BAALC患者相比，高BAALC患者的无复发生存期（RFS, P = 0.0008）和总生存期（OS, P = 0.0001）较低。相比之下，ERG和BAALC均低表达的患者（占所有T-ALL患者的41%）具有最有利的结果（P < 0.0001； 4年RFS：低ERG/低BAALC 81%； P < 0.0001； 4年OS：低ERG/低BAALC 69%）。在多变量分析中，低ERG/低BAALC表达是独立的有利预后意义（RFS, P = 0.001； OS, P = 0.003）。结论ERG和BAALC的低表达表明T-ALL患者具有明显有利的长期预后。
PurposeExpression of the genes ERG ( v-ets erythroblastosis virus E26 oncogene homolog) and BAALC ( brain and acute leukemia, cytoplasmic) shows similarity during hematopoietic maturation and predicts outcome in acute myeloid leukemia. We hypothesized that like ERG, BAALC expression might be of prognostic significance in acute T-lymphoblastic leukemia ( T-ALL) and that ERG and BAALC expression together would better identify the patient's risk profile.Patients and MethodsERG and BAALC mRNA expression were determined by real-time reverse transcriptase polymerase chain reaction in 153 adults with T-ALL. Patients were designated low or high ERG expressers and low or high BAALC expressers.ResultsHigh BAALC expression correlated with a higher frequency of early T-ALL ( P < .0001), CD34 positivity ( P < .0001), coexpression of myeloid markers ( P = .0001), and high ERG expression ( P = .03). High BAALC compared with low BAALC patients had an inferior relapse-free survival ( RFS; P = .0008) and overall survival ( OS; P = .0001). In contrast, patients with low expression of both ERG and BAALC ( representing 41% of all T-ALL patients) had the most favorable outcome ( P < .0001; 4-year RFS: low ERG/low BAALC 81%; P < .0001; 4-year OS: low ERG/low BAALC 69%). On multivariable analysis, low ERG/low BAALC expression was of independent favorable prognostic significance ( RFS, P = .001; OS, P = .003).ConclusionLow expression of both ERG and BAALC identifies T-ALL patients with a distinctly favorable long-term outcome.