Ferrando Adolfo A, Neuberg Donna S, Dodge Richard K, Paietta Elisabeth, Larson Richard A, Wiernik Peter H, Rowe Jacob M, Caligiuri Michael A, Bloomfield Clara D, Look A Thomas
Department of Pediatric Oncology, Dana-Farber Cancer Institute/Harvard School of Public Health, 44 Binney Street, Mayer-630, Boston 02115, MA, USA.
Lancet. 2004 Feb 14;363(9408):535-6. doi: 10.1016/S0140-6736(04)15542-6.
The activation of oncogenic transcription factors defines distinct molecular subsets of T-cell acute lymphoblastic leukaemia and has prognostic relevance in children. We investigated the prognostic effect of the expression levels of eight oncogenic transcription factors--TLX1 (HOX11), TLX3 (HOX11L2), TAL1, TAL2, LYL1, OLIG2 (BHLHB1), LMO1, and LMO2--in 52 adults with T-cell acute lymphoblastic leukaemia. The leukaemia-specific survival rate for the 16 TLX1-positive patients was 88% (90% CI 73-100%), compared with 56% (42-70%) for all other cases (p=0.019). Only the TLX1 oncogene expression subgroup showed difference in leukaemia-specific survival. Our results suggest that overexpression of TLX1 confers a good outlook for adults with T-cell acute lymphoblastic leukaemia. Furthermore, our findings lead to questions about whether stem-cell transplantation in first remission is necessary for effective treatment of patients in the low-risk subgroup of patients with TLX1 oncogene expression.
致癌转录因子的激活定义了T细胞急性淋巴细胞白血病的不同分子亚群，并且对儿童具有预后相关性。我们研究了8种致癌转录因子——TLX1（HOX11）、TLX3（HOX11L2）、TAL1、TAL2、LYL1、OLIG2（BHLHB1）、LMO1和LMO2——的表达水平对52例成人T细胞急性淋巴细胞白血病患者的预后影响。16例TLX1阳性患者的白血病特异性生存率为88%（90%CI 73-100%），而所有其他病例为56%（42-70%）（p=0.019）。只有TLX1致癌基因表达亚组在白血病特异性生存率方面存在差异。我们的结果表明，TLX1的过表达为成人T细胞急性淋巴细胞白血病患者带来良好的预后前景。此外，我们的研究结果引发了关于对于TLX1致癌基因表达的低风险亚组患者，首次缓解期进行干细胞移植对于有效治疗是否必要的疑问。
