Choi Jaewon, Hwang Yu Kyeong, Sung Ki Woong, Lee Soo Hyun, Yoo Keon Hee, Jung Hye Lim, Koo Hong Hoe, Kim Hee-Jin, Kang Hyong Jin, Shin Hee Young, Ahn Hyo Seop
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul, South Korea 135-710.
Blood. 2007 Jan 15;109(2):471-7. doi: 10.1182/blood-2006-07-032557. Epub 2006 Sep 21.
Livin, a member of the inhibitor of apoptosis proteins, has been considered to be a poor prognostic marker in malignancies. However, little is known about the clinical relevance of Livin expression in childhood acute lymphoblastic leukemia (ALL). In this study, the expression of Livin was analyzed in 222 patients with childhood ALL using quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) to investigate a possible association with the clinical features at diagnosis and treatment outcomes. Both Livin expression rates and expression levels were higher in patients with favorable prognostic factors. The expression rate was also higher in patients with a favorable day 7 bone marrow response to induction chemotherapy (P<.001). The Livin expression was related to the absence of relapse (P<.001). Similarly, the relapse-free survival rate (+/-95% CI) was higher in patients with Livin expression than in patients without Livin expression (97.9%+/-4.0% versus 64.9%+/-11.8%, P<.001). Multivariate analysis for relapse-free survival demonstrated that Livin expression was an independent favorable prognostic factor in childhood ALL (P=.049). This study suggests that Livin expression is a novel prognostic marker in childhood ALL and thus needs to be incorporated into the patient stratification and treatment protocols.
生存素（Livin）是凋亡抑制蛋白家族的成员之一，被认为是恶性肿瘤中预后不良的标志物。然而，关于生存素在儿童急性淋巴细胞白血病（ALL）中的表达与临床相关性知之甚少。在本研究中，采用定量逆转录聚合酶链反应（RT-PCR）分析了222例儿童ALL患者生存素的表达情况，以探讨其与诊断时临床特征及治疗结果之间可能存在的关联。具有良好预后因素的患者生存素表达率及表达水平均较高。诱导化疗第7天骨髓反应良好的患者生存素表达率也较高（P<0.001）。生存素表达与无复发相关（P<0.001）。同样，生存素表达阳性患者的无复发生存率（±95%CI）高于生存素表达阴性患者（97.9%±4.0%对64.9%±11.8%，P<0.001）。无复发生存的多因素分析表明，生存素表达是儿童ALL独立的良好预后因素（P=0.049）。本研究提示，生存素表达是儿童ALL一种新的预后标志物，因此需要纳入患者分层及治疗方案中。
