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淋巴增强结合因子 1(LEF1)高表达是细胞遗传学正常的急性髓系白血病的一个新的有利预后因素。

High expression of lymphoid enhancer-binding factor-1 (LEF1) is a novel favorable prognostic factor in cytogenetically normal acute myeloid leukemia.

机构信息

Department of Internal Medicine III and Laboratory for Leukemia Diagnostics, Ludwig-Maximilians-Universität, Munich, Germany.

出版信息

Blood. 2012 Sep 6;120(10):2118-26. doi: 10.1182/blood-2012-02-411827. Epub 2012 Jul 18.

Abstract

Lymphoid enhancer-binding factor-1 (LEF1) is a key transcription factor of Wnt signaling. We recently showed that aberrant LEF1 expression induces acute myeloid leukemia (AML) in mice, and found high LEF1 expression in a subset of cytogenetically normal AML (CN-AML) patients. Whether LEF1 expression associates with clinical and molecular patient characteristics and treatment outcomes remained unknown. We therefore studied LEF1 expression in 210 adults with CN-AML treated on German AML Cooperative Group trials using microarrays. High LEF1 expression (LEF1high) associated with significantly better relapse-free survival (RFS; P < .001), overall survival (OS; P < .001), and event-free survival (EFS; P < .001). In multivariable analyses adjusting for established prognosticators, LEF1high status remained associated with prolonged RFS (P = .007), OS (P = .01), and EFS (P = .003). In an independent validation cohort of 196 CN-AML patients provided by the German-Austrian AML Study Group, LEF1high patients had significantly longer OS (P = .02) and EFS (P = .04). We validated the prognostic relevance of LEF1 expression by quantitative PCR, thereby providing a clinically applicable platform to incorporate this marker into future risk-stratification systems for CN-AML. Gene-expression profiling and immunophenotyping revealed up-regulation of lymphopoiesis-related genes and lymphoid cell-surface antigens in LEF1high patients. In summary, we provide evidence that high LEF1 expression is a novel favorable prognostic marker in CN-AML.

摘要

淋巴增强因子结合因子 1(LEF1)是 Wnt 信号通路的关键转录因子。我们最近发现异常表达的 LEF1 可诱导小鼠发生急性髓系白血病(AML),并在一部分细胞遗传学正常的 AML(CN-AML)患者中发现 LEF1 高表达。然而,LEF1 表达是否与临床和分子患者特征以及治疗结果相关仍不清楚。因此,我们使用微阵列研究了德国 AML 协作组试验中 210 例 CN-AML 成年患者的 LEF1 表达情况。高 LEF1 表达(LEF1high)与显著更好的无复发生存率(RFS;P<.001)、总生存率(OS;P<.001)和无事件生存率(EFS;P<.001)显著相关。在调整了既定预后因素的多变量分析中,LEF1high 状态与延长的 RFS(P=.007)、OS(P=.01)和 EFS(P=.003)仍然相关。在由德国-奥地利 AML 研究组提供的 196 例 CN-AML 患者的独立验证队列中,LEF1high 患者的 OS(P=.02)和 EFS(P=.04)显著更长。我们通过定量 PCR 验证了 LEF1 表达的预后相关性,从而为将该标志物纳入未来 CN-AML 的风险分层系统提供了一种临床适用的平台。基因表达谱分析和免疫表型分析显示,LEF1high 患者中与淋巴样细胞相关的基因和细胞表面抗原表达上调。综上所述,我们提供的证据表明,LEF1 高表达是 CN-AML 的一种新的有利预后标志物。

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