Investigation of Potential Prognostic Biomarkers in Pediatric Acute Lymphoblastic Leukemia

Acute lymphoblastic leukemia (ALL) is the most common type of childhood cancer and identifying prognostic biomarkers for pediatric ALL is critical for improving outcomes. In this study, we aimed to investigate CXCR4, PDGFR-β, RANTES, TWIST1, and VEGFR2 genes as candidate prognostic biomarkers associated with pediatric ALL immunophenotypes. Bone marrow and peripheral blood mononuclear cells (PBMCs) of 46 pediatric ALL patients and healthy controls were collected. The expression of CXCR4, PDGFR-β, RANTES, TWIST1, and VEGFR2 genes, considered candidate prognostic biomarkers, was analysed using quantitative reverse transcription polymerase chain reaction (qRT-PCR). RANTES expression was upregulated in pre-B-ALL, pro-B-ALL, and T-ALL patients compared to healthy controls (p= 0.015). The expression of all targeted genes, except CXCR4, was elevated in patients with trisomies of chromosomes 1, 6, 8, 12, 17, 21, and 22 (p< 0.05). Increased CXCR4 and RANTES expression was observed in patients with the t(9;22) translocation (p= 0.039, p= 0.017, respectively). High PDGFR-β and RANTES expression was associated with prolonged remission duration (p= 0.007, p= 0.015, respectively). Additionally, CXCR4 expression was highest in the high risk (HR) group (p= 0.039). The results of this study indicate that RANTES and PDGFR-β may be potential prognostic biomarkers in pediatric ALL in the presence of common clinical features. Monitoring RANTES and PDGFR-β expressions could be a novel approach for determining and managing prognosis in pediatric ALL. The main limitation of the study is the collection of healthy bone marrow samples due to ethical concerns, which may require confirmation of our findings in larger cohorts. Keywords: Pediatric ALL, RANTES, PDGFR-β, Prognosis, Biomarker