Study of Transcription Factor CCAAT/ Enhancer Binding Protein Alpha (C/EBPα) In Adult Acute Lymphoblastic Leukemia Patients

Abstract

Background: leukemic stem cells (LSCs) have self renewal property. identification of genes or signaling pathways involved in self renewal of LCSs will promote the development of more effective treatment for acute leukemias. Objectives: To assess the prognostic significance of C/EBPα transcription factor in primary adult acute lymphoblastic leukemia (ALL) patients and its correlation to prognosis and response to therapy. Subjects and methods: 40 adult ALL patients (23 Pre-B ALL, 1 Pro-B ALL, 4 mature B ALL and 12 T ALL) were recruited from hematology department, Ain Shams University, compared to 25 age and sex matched healthy control. All patients were subjected to complete blood count, blood chemistry, bone marrow examination, immunophenotyping, cytogenetics and assessment of CEBPα level using Real Time- Polymerase Chain Reaction (RT-PCR) for all studied subjects at presentation and at D28 of treatment. Patients were followed over a period of 24 months (1-24 ms). Results: Compared to controls, ALL patients at presentation and at follow up showed highly significant difference regarding CEBPα (P˂0.01) while there was no significant difference between B ALL and T ALL. Remitted patients showed significant increase in CEBPα after treatment. There was no significant correlation between CEPBα and other prognostic factors in ALL except with Philadelphia chromosome; there was a significantly negative correlation at diagnosis and at follow up. Conclusion: Deficient CEBPα among ALL patients may contribute to its pathogenesis and remission is associated with significant increase in CEBPα level. CEBPα is an independent prognostic factor and its measurement helps to predict response and adds significantly for better management decisions.