Classification of pediatric acute lymphoblastic leukemia by gene expression profiling.
Contemporary treatment of pediatric acute lymphoblastic leukemia (ALL) requires the assignment of patients to specific risk groups. We have recently demonstrated that expression profiling of leukemic blasts can accurately identify the known prognostic subtypes of ALL, including T-cell lineage ALL (T-ALL), E2A-PBX1, TEL-AML1, MLL rearrangements, BCR-ABL, and hyperdiploid karyotypes with more than 50 chromosomes. As the next step toward developing this methodology into a frontline diagnostic tool, we have now analyzed leukemic blasts from 132 diagnostic samples using higher density oligonucleotide arrays that allow the interrogation of most of the identified genes in the human genome. Nearly 60% of the newly identified subtype discriminating genes are novel markers not identified in our previous study, and thus should provide new insights into the altered biology underlying these leukemias. Moreover, a proportion of the newly selected genes are highly ranked as class discriminators, and when incorporated into class-predicting algorithms resulted in an overall diagnostic accuracy of 97%. The performance of an array containing the identified discriminating genes should now be assessed in frontline clinical trials in order to determine the accuracy, practicality, and cost effectiveness of this methodology in the clinical setting.
Department of Hematology-Oncology, St Jude Children's Research Hospital, 332 N. Lauderdale, Memphis, TN 38105, USA.
Mary E
ME
Ross
Xiaodong
X
Zhou
Guangchun
G
Song
Sheila A
SA
Shurtleff
Kevin
K
Girtman
W Kent
WK
Williams
Hsi-Che
HC
Liu
Rami
R
Mahfouz
Susana C
SC
Raimondi
Noel
N
Lenny
Anami
A
Patel
James R
JR
Downing
D000465:Algorithms; D001853:Bone Marrow / Q000378:metabolism; D015973:Gene Expression Regulation, Leukemic; D006801:Humans; D007621:Karyotyping; D016571:Neural Networks, Computer; D020411:Oligonucleotide Array Sequence Analysis; D010802:Phylogeny; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000145:classification* / Q000175:diagnosis / Q000235:genetics*; D011379:Prognosis