Serum HOX transcript antisense RNA expression as a diagnostic marker for chronic myeloid leukemia

Abstract

Background The diagnosis of chronic myeloid leukemia (CML) is complex based mainly on the presence of Philadelphia chromosome with morphological characteristics and leukocyte alkaline phosphatase (LAP) score. However, it can be confused and should be differentiated from different disorders including specifically the leukemoid reaction (LR). HOX transcript antisense RNA (HOTAIR) expression may be a useful biomarker for detection of cancer. Objective This study was aimed to explore the accuracy of HOTAIR as a diagnostic marker for CML. Patients and methods During the period from 1 February 2017 till 31 December 2018, patients with CML and LR were enrolled in this study. The LAP score was assessed for all patients by cytochemistry on their peripheral blood smear. HOTAIR expression was relatively quantified using the RT-qPCR technique. The diagnostic accuracy of serum HOTAIR expression in differentiating both groups was evaluated. Results A total of 66 patients were included and assigned into two groups; CML patients (group I) and LR patients (group II). The serum HOTAIR expression level was significantly higher in the CML group than the LR group (P<0.001). The area under curve (AUC) of the serum HOTAIR was detected as 0.883 with a sensitivity of 67.7% and a specificity of 85.7% at a cutoff more than 2.8 for CML diagnosis which is slightly higher than that for the LAP score (AUC difference=0.0369; P=0.334). The increased serum HOTAIR expression is independently related with poor clinical, laboratory features of CML and the decreased LAP score. The diagnostic accuracy of HOTAIR was detected to be increased if combined with the LAP score (AUC=0.900). Conclusion Our study findings suggested that the serum HOTAIR can serve as a potential marker for the CML with high diagnostic accuracy specifically if combined with the LAP score.