Abstract

Acute lymphoblastic leukemia (ALL) is a neoplastic disease that results from multistep somatic mutations in a single lymphoid progenitor cell. MicroRNAs (miRNAs) are critical regulators of gene expression, tumor suppression, and oncogenesis. <h3>Aim:</h3> To evaluate miRNA-511 and miRNA-16 expression in Egyptian adult B-ALL. <h3>Subjects and Methods:</h3> 37 newly diagnosed adult B-ALL patients admitted to Alexandria Main University Hospital in 2019. Investigations included CBC, bone marrow aspiration, immunophenotyping, BCR-ABL testing, karyotyping, miRNA extraction using miRNeasy Mini Kit, qRT-PCR combined with cDNA synthesis from RNA templates using miScript II RT Kit, followed by real-time PCR for miR-511 and miR-16 expression analysis. <h3>Results:</h3> Mean age of ALL patients was 30.65 ± 10.39 years, with a male to female ratio of 1.4:1. Cytogenetic findings showed only 3 patients had favorable risk, and the rest were either intermediate risk (19) or high risk (15). Among the high-risk group, 11 patients were Philadelphia (BCR-ABL 190)-positive. Regarding the expression of the miRNAs, most patients showed the overexpression of both miR-16 and miR-511. MiR-511 was overexpressed in 81.1% (30) of patients; among these patients, 43.3% (13) had adverse cytogenetic findings. MiR-16 was overexpressed in 70.3% (26) of patients; half of them (13) had adverse cytogenetic findings. ROC curves showed the diagnostic significance in B-ALL of miR-16, with a sensitivity of 75.7% and a specificity of 80%; for miR-511, the sensitivity was 89.2%, and specificity was 90%, (p<0.05). Among the studied group, 9 (24%) patients developed COVID-19 viral infection, and of those, 3 (33%) patients died, comprising 21% of all deaths. The three patients were either refractory or relapsed and treated mostly as palliative cases. <h3>Conclusion:</h3> MiR-16 and miR-511 were significantly overexpressed in adult B-ALL. They have a role in diagnosis but a weak role in patients' prognosis.

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