Abstract
BackgroundB-Acute lymphoblastic leukemia (B-ALL) represents a hematologic malignancy with poor clinical outcome and low survival rates in adult patients. Remission rates in Hispanic population are almost 30 % lower and Overall Survival (OS) nearly two years inferior than those reported in other ethnic groups. Only 61 % of Colombian adult patients with ALL achieve complete remission (CR), median overall survival is 11.3 months and event-free survival (EFS) is 7.34 months. Identification of prognostic factors is crucial for the application of proper treatment strategies and subsequently for successful outcome. Our goal was to identify a gene expression signature that might correlate with response to therapy and evaluate the utility of these as prognostic tool in hispanic patients.MethodsWe included 43 adult patients newly diagnosed with B-ALL. We used microarray analysis in order to identify genes that distinguish poor from good response to treatment using differential gene expression analysis. The expression profile was validated by real-time PCR (RT-PCT).ResultsWe identified 442 differentially expressed genes between responders and non-responders to induction treatment. Hierarchical analysis according to the expression of a 7-gene signature revealed 2 subsets of patients that differed in their clinical characteristics and outcome.ConclusionsOur study suggests that response to induction treatment and clinical outcome of Hispanic patients can be predicted from the onset of the disease and that gene expression profiles can be used to stratify patient risk adequately and accurately. The present study represents the first that shows the gene expression profiling of B-ALL Colombian adults and its relevance for stratification in the early course of disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s13046-016-0333-z) contains supplementary material, which is available to authorized users.
Highlights
B-Acute lymphoblastic leukemia (B-ALL) represents a hematologic malignancy with poor clinical outcome and low survival rates in adult patients
Forty-three samples from adult patients diagnosed with precursor B-ALL were analyzed in this study (41 bone marrow (BM) and 2 peripheral blood (PB) samples obtained at diagnosis)
Patient characteristics This study included 43 adult patients newly diagnosed with Common and Pre-B B-precursor acute lymphoblastic leukemia (B-ALL)
Summary
B-Acute lymphoblastic leukemia (B-ALL) represents a hematologic malignancy with poor clinical outcome and low survival rates in adult patients. 61 % of Colombian adult patients with ALL achieve complete remission (CR), median overall survival is 11.3 months and event-free survival (EFS) is 7.34 months. Intensive chemotherapeutic schemes have been implemented in adults for more than a decade in the United States and other countries [9,10,11,12,13,14] and have led to higher rates of durable remissions in Colombia these schemes have shown disappointing results with a median OS of less than 11.3 months, EFS of only 7.34 months, and only 61 % achieve CR [15]. It is interesting to explore the underlying molecular characteristics of the disease in Colombian patients
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