Context Chronic lymphocytic leukemia (CLL), a hematologic malignancy, characterized by progressive accumulation of mature B lymphocytes. The role of Wnt signaling pathway has been reported in CLL biogenesis. Lymphoid enhancer-binding factor-1 (LEF1), a mediator of this canonical pathway has been identified in CLL. Objective To analyze Wnt signaling pathway members (WNT3) and its key mediator LEF1 expression levels in CLL patients and to assess their potential role as markers of CLL outcome. Design An observational prospective study from February 2017 till February 2018. Setting It was carried out in the Hematology unit at Oncology Center Mansoura University (OCMU). Patients This study was carried out on 35 newly diagnosed CLL patients in comparison with 15 adult controls, they were M/F 14/16 (47/53%), median age 63. Interventions The patients were subjected to history taking, physical examination and laboratory investigations of CLL. Wnt3 gene and LEF1 expression levels in peripheral blood of untreated CLL mononuclear cells and normal healthy controls were determined by RT-PCR. Main outcome measures Our study demonstrated significant upregulation of both Wnt3 and LEF1 in CLL PBMNC in comparison to healthy controls (P Results WNT3 and LEF1 were significantly decreased in CLL patients with ECOG 2&3 P=0.023 and 0.007, respectively. Untreated CLL patients harboring 17p deletion expressed significantly low LEF1 (P=0.033). A significant positive association was observed between WNT3 and LEF1 levels (Spearman r=0.74, P Conclusions WNT3 and its key mediator LEF1 were shown to be overexpressed and activated in CLL cells in comparison to healthy persons. Raising the interest that antagonizing Wnt signaling in CLL may represent an effective treatment potential. Interestingly, low expression of both WNT3 and LEF1 were associated with shortened survival in CLL patients which trigger more studies on a larger patient cohort.
Read full abstract