The prognostic significance of CRLF2 expression at diagnosis in adult Ph-negative B-cell precursor acute lymphoblastic leukemia

Abstract

The prognostic significance of cytokine receptor like factor 2 (CRLF2) expression at diagnosis in adult B-cell precursor acute lymphoblastic leukemia (BCP-ALL) needs to be clarified. A total of 357 bone marrow samples collected from consecutive adult cases with Ph-negative BCP-ALL at diagnosis retrospectively detected CRLF2 transcript levels by real-time quantitative PCR. Twenty percent was selected as the cutoff value for CRLF2 to divide patients into CRLF2_H and CRLF2_L groups. CRLF2_H was associated with higher WBC count, P2RY8–CRLF2 fusion and IKZF1 deletions (IKZF1del). In both the whole cohort and B-other patients, CRLF2_H independently predicted lower CR rates after induction. Furthermore, CRLF2_H/IKZF1del(+) patients had significantly lower CR, RFS, and OS rates and tended to have lower RFS and OS rates than others in the whole cohort and B-other patients, respectively. Therefore, coexistence of CRLF2_H and IKZF1del at diagnosis predicts poor response and outcome in adult Ph-negative BCP-ALL.

Keywords:

• Ph-negative B cell precursor acute lymphoblastic leukemia
• adult
• CRLF2 transcript levels
• B-other
• real-time PCR

Author contributions

YZQ and QJ designed the research. JW, KS, and YZQ wrote and revised the manuscript. WMC, XW, LDL, and YH performed experiments. KS, JW, and NX analyzed the data. HJ, LPX, YW, and XHZ helped to collect the clinical samples and data. XJH provided critical review of manuscript. All authors read and approved the final manuscript for submission.

Ethical approval

The study was conducted in accordance with the Declaration of Helsinki and was approved by the ethics committee of Peking University People’s Hospital.

Disclosure statement

The authors declare no conflict of interest.

Data availability statement

The data underlying this article cannot be shared publicly to protect the confidentiality of individuals that participated in the study, but are available from the corresponding author upon reasonable request.

Additional information

Funding

This work was supported by the Capital’s Funds for Health Improvement and Research of China (2020-2Z-40811).