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Secondary acute lymphoblastic leukemia, a retrospective analysis from Washington University and meta-analysis of published data.

ABSTRACT: Secondary acute lymphoblastic leukemia (s-ALL) is rare and poorly defined and data regarding outcomes post-transplant are lacking. Here, we report a detailed analysis of s-ALL at our Institution. Among 211 eligible patients with ALL from 2006 to 2017, 30 (14%) were defined as s-ALL and the remaining as primary ALL (p-ALL). s-ALL patients were older and had higher incidence of adverse risk factors. Overall response (OR) after induction was not different between s-ALL and p-ALL (79% versus 90% respectively, p?=?0.106). S-ALL group had a higher risk of relapse (RFS) and death (RFS HR?=?1.93, 95% CI 1.2-3.12, p?=?0.007. OS HR: =1.95, 95% CI 1.18-3.23, p?=?0.01). In multivariate analysis, the adverse effect of s-ALL on RFS and OS was no longer significant, however a pooled meta-analysis of our and published data indicated that s-ALL is an independent risk factor for lower OS (HR: 1.30, 95% CI: 1.11-1.52, p?

SUBMITTER: Ferraro F

PROVIDER: S-EPMC7735253 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Secondary acute lymphoblastic leukemia, a retrospective analysis from Washington University and meta-analysis of published data.

Ferraro Francesca F Gao Feng F Stockerl-Goldstein Keith K Westervelt Peter P DiPersio John F JF Ghobadi Armin A

Leukemia research 20180731

Secondary acute lymphoblastic leukemia (s-ALL) is rare and poorly defined and data regarding outcomes post-transplant are lacking. Here, we report a detailed analysis of s-ALL at our Institution. Among 211 eligible patients with ALL from 2006 to 2017, 30 (14%) were defined as s-ALL and the remaining as primary ALL (p-ALL). s-ALL patients were older and had higher incidence of adverse risk factors. Overall response (OR) after induction was not different between s-ALL and p-ALL (79% versus 90% res ...[more]

PMID: 30114560

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Project description:Relapsed pediatric B-acute lymphoblastic leukemia (B-ALL) remains as the leading cause of cancer death among children. Other than stem cell transplantation and intensified chemotherapy, no other improved treatment strategies have been approved clinically. Gene expression profiling represents a powerful approach to identify potential biomarkers and new therapeutic targets for various diseases including leukemias. However, inadequate sample size in many individual experiments has failed to provide adequate study power to yield translatable findings. With the hope of getting new insights into the biological mechanisms underpinning relapsed ALL and identifying more promising biomarkers or therapeutic targets, we conducted a meta-analysis of gene expression studies involving ALL from 3 separate studies.By using the keywords "acute lymphoblastic leukemia", and "microarray", a total of 280 and 275 microarray datasets were found listed in Gene Expression Omnibus database GEO and ArrayExpress database respectively. Further manual inspection found that only three studies (GSE18497, GSE28460, GSE3910) were focused on gene expression profiling of paired diagnosis-relapsed pediatric B-ALL. These three datasets which comprised of a total of 108 matched diagnosis-relapsed pediatric B-ALL samples were then included for this meta-analysis using RankProd approach.Our analysis identified a total of 1795 upregulated probes which corresponded to 1527 genes (pfp?<?0.01; FC?>?1), and 1493 downregulated probes which corresponded to 1214 genes (pfp?<?0.01; FC?<?1) respectively. S100A8 appeared as the top most overexpressed gene (pfp?<?0.01, FC?=?1.8) and is a potential target for further validation. Based on gene ontology biological process annotation, the upregulated genes were most enriched in cell cycle processes (enrichment score?=?15.3), whilst the downregulated genes were clustered in transcription regulation (enrichment score?=?12.6). Elevated expression of cell cycle regulators (e.g kinesins, AURKA, CDKs) was the key genetic defect implicated in relapsed ALL, and serve as attractive targets for therapeutic intervention.We identified S100A8 as the most overexpressed gene, and the cell cycle pathway as the most promising biomarker and therapeutic target for relapsed childhood B-ALL. The validity of the results warrants further investigation.

Dataset Information

Secondary acute lymphoblastic leukemia, a retrospective analysis from Washington University and meta-analysis of published data.

Publications

Secondary acute lymphoblastic leukemia, a retrospective analysis from Washington University and meta-analysis of published data.

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