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Organista-Nava J, Gómez-Gómez Y, Illades-Aguiar B, Rivera-Ramírez AB, Saavedra-Herrera MV, Leyva-Vázquez MA. Overexpression of dihydrofolate reductase is a factor of poor survival in acute lymphoblastic leukemia. Oncol Lett 2018; 15:8405-8411. [PMID: 29805575 PMCID: PMC5950508 DOI: 10.3892/ol.2018.8429] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 08/23/2017] [Indexed: 11/05/2022] Open
Abstract
Dihydrofolate reductase (DHFR) has an important function in DNA synthesis and is a target of methotrexate, which is a crucial treatment option for acute lymphoblastic leukemia (ALL). However, the number of studies conducted to date on DHFR expression in childhood ALL is limited. The aim of the present study was to determine whether the expression of DHFR is associated with survival in childhood ALL. The expression of DHFR in 96 children with ALL and 100 control individuals was determined using reverse transcription-quantitative polymerase chain reaction. The results of the present study demonstrated that the expression of DHFR mRNA in children with ALL was significantly increased (P<0.001), compared with that in the control group. In addition, increased levels of DHFR mRNA were observed in patients with B-cell lineage, compared with patients with T-cell lineage ALL (P<0.05). The Kaplan-Meier estimator analysis revealed that children with ALL who exhibited increased levels of DHFR mRNA had a decreased overall survival time (P<0.05). It was observed that certain patient prognostic features (including age, sex, white blood cell count and high DHFR expression), are associated with poor survival (log-rank test, P<0.05). Therefore, the results of the present study indicated that DHFR upregulation is a factor for poor survival in ALL.
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Affiliation(s)
- Jorge Organista-Nava
- Laboratory of Molecular Biomedicine, School of Chemical-Biological Sciences, Guerrero State University, Chilpancingo, Guerrero 39090, Mexico
| | - Yazmín Gómez-Gómez
- Laboratory of Molecular Biomedicine, School of Chemical-Biological Sciences, Guerrero State University, Chilpancingo, Guerrero 39090, Mexico
| | - Berenice Illades-Aguiar
- Laboratory of Molecular Biomedicine, School of Chemical-Biological Sciences, Guerrero State University, Chilpancingo, Guerrero 39090, Mexico
| | - Ana Bertha Rivera-Ramírez
- Research Department, State Cancer Institute, Arturo Beltran Ortega, Acapulco, Guerrero 39570, Mexico
| | | | - Marco Antonio Leyva-Vázquez
- Laboratory of Molecular Biomedicine, School of Chemical-Biological Sciences, Guerrero State University, Chilpancingo, Guerrero 39090, Mexico
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Organista-Nava J, Gómez-Gómez Y, Illades-Aguiar B, Del Carmen Alarcón-Romero L, Saavedra-Herrera MV, Rivera-Ramírez AB, Garzón-Barrientos VH, Leyva-Vázquez MA. High miR-24 expression is associated with risk of relapse and poor survival in acute leukemia. Oncol Rep 2015; 33:1639-49. [PMID: 25672522 PMCID: PMC4358084 DOI: 10.3892/or.2015.3787] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 01/21/2015] [Indexed: 11/16/2022] Open
Abstract
MicroRNAs (miRNAs) play an essential role in the development and progression of acute leukemia (AL). miR-24 promotes the survival of hematopoietic cells. However, little is known concerning the function of miR-24 in human AL. The aim of the present study was to investigate the clinical significance of miR-24 expression in AL. miR-24 expression in 147 patients with AL and 100 healthy individuals was measured by quantitative reverse transcriptase-polymerase chain reaction (RT-qPCR). The results showed that compared with the healthy individuals, the expression of miR-24 in AL patients was significantly higher (p<0.001). In addition, miR-24 was expressed at significantly higher levels in acute myeloid leukemia (AML) patients and at significantly lower levels in acute lymphoblastic leukemia (ALL) (p<0.001). More importantly, Kaplan-Meier analysis showed that AL patients with high miR-24 expression tended to have shorter overall survival (p<0.05). In the multivariate analysis stratified for known prognostic variables, miR-24 was identified as an independent prognostic marker. Our data indicated that miR-24 upregulation was associated with poor prognosis in AL. miR-24 was identified for the first time as an independent marker for predicting the clinical outcome of AL patients.
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Affiliation(s)
- Jorge Organista-Nava
- Institute of Cellular Physiology, National Autonomous University of Mexico (UNAM), University City, D.F., Mexico
| | - Yazmín Gómez-Gómez
- Research Department, State Cancer Institute, 'Arturo Beltran Ortega', Acapulco, Guerrero, Mexico
| | - Berenice Illades-Aguiar
- Laboratory of Molecular Biomedicine, School of Chemical-Biological Sciences, Guerrero State University, Chilpancingo, Guerrero, Mexico
| | - Luz Del Carmen Alarcón-Romero
- Laboratory of Cytopathology, School of Chemical-Biological Sciences, Guerrero State University, Chilpancingo, Guerrero, Mexico
| | | | | | | | - Marco Antonio Leyva-Vázquez
- Laboratory of Molecular Biomedicine, School of Chemical-Biological Sciences, Guerrero State University, Chilpancingo, Guerrero, Mexico
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Yeoh AEJ, Ariffin H, Chai ELL, Kwok CSN, Chan YH, Ponnudurai K, Campana D, Tan PL, Chan MY, Kham SKY, Chong LA, Tan AM, Lin HP, Quah TC. Minimal Residual Disease–Guided Treatment Deintensification for Children With Acute Lymphoblastic Leukemia: Results From the Malaysia-Singapore Acute Lymphoblastic Leukemia 2003 Study. J Clin Oncol 2012; 30:2384-92. [DOI: 10.1200/jco.2011.40.5936] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To improve treatment outcome for childhood acute lymphoblastic leukemia (ALL), we designed the Malaysia-Singapore ALL 2003 study with treatment stratification based on presenting clinical and genetic features and minimal residual disease (MRD) levels measured by polymerase chain reaction targeting a single antigen-receptor gene rearrangement. Patients and Methods Five hundred fifty-six patients received risk-adapted therapy with a modified Berlin-Frankfurt-Münster–ALL treatment. High-risk ALL was defined by MRD ≥ 1 × 10−3 at week 12 and/or poor prednisolone response, BCR-ABL1, MLL gene rearrangements, hypodiploid less than 45 chromosomes, or induction failure; standard-risk ALL was defined by MRD ≤ 1 × 10−4 at weeks 5 and 12 and no extramedullary involvement or high-risk features. Intermediate-risk ALL included all remaining patients. Results Patients who lacked high-risk presenting features (85.7%) received remission induction therapy with dexamethasone, vincristine, and asparaginase, without anthracyclines. Six-year event-free survival (EFS) was 80.6% ± 3.5%; overall survival was 88.4% ± 3.1%. Standard-risk patients (n = 172; 31%) received significantly deintensified subsequent therapy without compromising EFS (93.2% ± 4.1%). High-risk patients (n = 101; 18%) had the worst EFS (51.8% ± 10%); EFS was 83.6% ± 4.9% in intermediate-risk patients (n = 283; 51%). Conclusion Our results demonstrate significant progress over previous trials in the region. Three-drug remission-induction therapy combined with MRD-based risk stratification to identify poor responders is an effective strategy for childhood ALL.
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Affiliation(s)
- Allen Eng Juh Yeoh
- Allen Eng Juh Yeoh, Elaine Li Leng Chai, Cecilia Sze Nga Kwok, Yiong Huak Chan, Dario Campana, Poh Lin Tan, Shirley Kow Yin Kham, and Thuan Chong Quah, Yong Loo Lin School of Medicine, National University of Singapore; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, Viva-University Children's Cancer Centre, University Children's Medical Institute, National University Hospital; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, National University Cancer Institute of Singapore, National
| | - Hany Ariffin
- Allen Eng Juh Yeoh, Elaine Li Leng Chai, Cecilia Sze Nga Kwok, Yiong Huak Chan, Dario Campana, Poh Lin Tan, Shirley Kow Yin Kham, and Thuan Chong Quah, Yong Loo Lin School of Medicine, National University of Singapore; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, Viva-University Children's Cancer Centre, University Children's Medical Institute, National University Hospital; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, National University Cancer Institute of Singapore, National
| | - Elaine Li Leng Chai
- Allen Eng Juh Yeoh, Elaine Li Leng Chai, Cecilia Sze Nga Kwok, Yiong Huak Chan, Dario Campana, Poh Lin Tan, Shirley Kow Yin Kham, and Thuan Chong Quah, Yong Loo Lin School of Medicine, National University of Singapore; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, Viva-University Children's Cancer Centre, University Children's Medical Institute, National University Hospital; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, National University Cancer Institute of Singapore, National
| | - Cecilia Sze Nga Kwok
- Allen Eng Juh Yeoh, Elaine Li Leng Chai, Cecilia Sze Nga Kwok, Yiong Huak Chan, Dario Campana, Poh Lin Tan, Shirley Kow Yin Kham, and Thuan Chong Quah, Yong Loo Lin School of Medicine, National University of Singapore; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, Viva-University Children's Cancer Centre, University Children's Medical Institute, National University Hospital; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, National University Cancer Institute of Singapore, National
| | - Yiong Huak Chan
- Allen Eng Juh Yeoh, Elaine Li Leng Chai, Cecilia Sze Nga Kwok, Yiong Huak Chan, Dario Campana, Poh Lin Tan, Shirley Kow Yin Kham, and Thuan Chong Quah, Yong Loo Lin School of Medicine, National University of Singapore; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, Viva-University Children's Cancer Centre, University Children's Medical Institute, National University Hospital; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, National University Cancer Institute of Singapore, National
| | - Kuperan Ponnudurai
- Allen Eng Juh Yeoh, Elaine Li Leng Chai, Cecilia Sze Nga Kwok, Yiong Huak Chan, Dario Campana, Poh Lin Tan, Shirley Kow Yin Kham, and Thuan Chong Quah, Yong Loo Lin School of Medicine, National University of Singapore; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, Viva-University Children's Cancer Centre, University Children's Medical Institute, National University Hospital; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, National University Cancer Institute of Singapore, National
| | - Dario Campana
- Allen Eng Juh Yeoh, Elaine Li Leng Chai, Cecilia Sze Nga Kwok, Yiong Huak Chan, Dario Campana, Poh Lin Tan, Shirley Kow Yin Kham, and Thuan Chong Quah, Yong Loo Lin School of Medicine, National University of Singapore; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, Viva-University Children's Cancer Centre, University Children's Medical Institute, National University Hospital; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, National University Cancer Institute of Singapore, National
| | - Poh Lin Tan
- Allen Eng Juh Yeoh, Elaine Li Leng Chai, Cecilia Sze Nga Kwok, Yiong Huak Chan, Dario Campana, Poh Lin Tan, Shirley Kow Yin Kham, and Thuan Chong Quah, Yong Loo Lin School of Medicine, National University of Singapore; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, Viva-University Children's Cancer Centre, University Children's Medical Institute, National University Hospital; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, National University Cancer Institute of Singapore, National
| | - Mei Yoke Chan
- Allen Eng Juh Yeoh, Elaine Li Leng Chai, Cecilia Sze Nga Kwok, Yiong Huak Chan, Dario Campana, Poh Lin Tan, Shirley Kow Yin Kham, and Thuan Chong Quah, Yong Loo Lin School of Medicine, National University of Singapore; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, Viva-University Children's Cancer Centre, University Children's Medical Institute, National University Hospital; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, National University Cancer Institute of Singapore, National
| | - Shirley Kow Yin Kham
- Allen Eng Juh Yeoh, Elaine Li Leng Chai, Cecilia Sze Nga Kwok, Yiong Huak Chan, Dario Campana, Poh Lin Tan, Shirley Kow Yin Kham, and Thuan Chong Quah, Yong Loo Lin School of Medicine, National University of Singapore; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, Viva-University Children's Cancer Centre, University Children's Medical Institute, National University Hospital; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, National University Cancer Institute of Singapore, National
| | - Lee Ai Chong
- Allen Eng Juh Yeoh, Elaine Li Leng Chai, Cecilia Sze Nga Kwok, Yiong Huak Chan, Dario Campana, Poh Lin Tan, Shirley Kow Yin Kham, and Thuan Chong Quah, Yong Loo Lin School of Medicine, National University of Singapore; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, Viva-University Children's Cancer Centre, University Children's Medical Institute, National University Hospital; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, National University Cancer Institute of Singapore, National
| | - Ah Moy Tan
- Allen Eng Juh Yeoh, Elaine Li Leng Chai, Cecilia Sze Nga Kwok, Yiong Huak Chan, Dario Campana, Poh Lin Tan, Shirley Kow Yin Kham, and Thuan Chong Quah, Yong Loo Lin School of Medicine, National University of Singapore; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, Viva-University Children's Cancer Centre, University Children's Medical Institute, National University Hospital; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, National University Cancer Institute of Singapore, National
| | - Hai Peng Lin
- Allen Eng Juh Yeoh, Elaine Li Leng Chai, Cecilia Sze Nga Kwok, Yiong Huak Chan, Dario Campana, Poh Lin Tan, Shirley Kow Yin Kham, and Thuan Chong Quah, Yong Loo Lin School of Medicine, National University of Singapore; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, Viva-University Children's Cancer Centre, University Children's Medical Institute, National University Hospital; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, National University Cancer Institute of Singapore, National
| | - Thuan Chong Quah
- Allen Eng Juh Yeoh, Elaine Li Leng Chai, Cecilia Sze Nga Kwok, Yiong Huak Chan, Dario Campana, Poh Lin Tan, Shirley Kow Yin Kham, and Thuan Chong Quah, Yong Loo Lin School of Medicine, National University of Singapore; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, Viva-University Children's Cancer Centre, University Children's Medical Institute, National University Hospital; Allen Eng Juh Yeoh, Poh Lin Tan, and Thuan Chong Quah, National University Cancer Institute of Singapore, National
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