Abstract

BackgroundHOXA family genes were crucial transcription factors involving cell proliferation and apoptosis. While few studies have focused on HOXA10 in AML. We aimed to investigate the prognostic significance of HOXA10.MethodsWe downloaded datasets from GEO and BeatAML database, to compare HOXA expression level between AML patients and controls. Kaplan-Meier curves were used to estimate the impact of HOXA10 expression on AML survival. The differentially expressed genes, miRNAs, lncRNAs and methylated regions between HOXA10-high and -low groups were obtained using R (version 3.6.0). Accordingly, the gene set enrichment analysis (GSEA) was accomplished using MSigDB database. Moreover, the regulatory TFs/microRNAs/lncRNAs of HOXA10 were identified. A LASSO-Cox model fitted OS to clinical and HOXA10-associated genetic variables by glmnet package.ResultsHOXA10 was overexpressed in AML patients than that in controls. The HOXA10-high group is significantly associated with shorter OS and DFS. A total of 1219 DEGs, 131 DEmiRs, 282 DElncRs were identified to be associated with HOXA10. GSEA revealed that 12 suppressed and 3 activated pathways in HOXA10-high group. Furthermore, the integrated regulatory network targeting HOXA10 was established. The LASSO-Cox model fitted OS to AML-survival risk scores, which included age, race, molecular risk, expression of IKZF2/LINC00649/LINC00839/FENDRR and has-miR-424-5p. The time dependent ROC indicated a satisfying AUC (1-year AUC 0.839, 3-year AUC 0.871 and 5-year AUC 0.813).ConclusionsOur study identified HOXA10 overexpression as an adverse prognostic factor for AML. The LASSO-COX regression analysis revealed novel prediction model of OS with superior diagnostic utility.

Highlights

  • homeobox protein HOX cluster A (HOXA) family genes were crucial transcription factors involving cell proliferation and apoptosis

  • Overexpression of HOXA10 in Acute myeloid leukemia (AML) The higher expression level of HOXA10 was revealed in AML patients than that in control group, in unsorted and CD34+ bone marrow cells (Fig. 1a-e)

  • HOXA10 expression signature was similar across different cell subpopulations of AML

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Summary

Introduction

HOXA family genes were crucial transcription factors involving cell proliferation and apoptosis. While few studies have focused on HOXA10 in AML. We aimed to investigate the prognostic significance of HOXA10. AML is characterized by unlimited clonal proliferation and accumulation of myeloid progenitors [1]. To estimate risk and survival of AML patients, quite a few prediction models have been developed. LeukemiaNet (ELN) 2017 risk stratification is the most commonly used risk model, which stratified AML patients based on recurrent cytogenetics and molecular mutations abnormalities [3]. A comprehensive evaluation of genetic variables is crucial for risk stratification and will guide treatment decisions. Other traditional prognostic factors include age, WBC count, LDH level etc.

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