title: Gene expression profiling identifies a subset of adult T-cell acute lymphoblastic leukemia with myeloid-like gene features and over-expression of miR-223.
abstract: BACKGROUND
  Until recently, few molecular aberrations were recognized in acute lymphoblastic leukemia of T-cell origin; novel lesions have recently been identified and a certain degree of overlap between acute myeloid leukemia and T-cell acute lymphoblastic leukemia has been suggested. To identify novel T-cell acute lymphoblastic leukemia entities, gene expression profiling was performed and clinico-biological features were studied.
  
  
  METHODS
  Sixty-nine untreated adults with T-cell acute lymphoblastic leukemia were evaluated by oligonucleotide arrays: unsupervised and supervised analyses were performed. The up-regulation of myeloid genes and miR-223 expression were validated by quantitative polymerase chain reaction analysis.
  
  
  RESULTS
  Using unsupervised clustering, we identified five subgroups. Of these, one branch included seven patients whose gene expression profile resembled that of acute myeloid leukemia. These cases were characterized by over-expression of a large set of myeloid-related genes for surface antigens, transcription factors and granule proteins. Real-time quantitative polymerase chain reaction analysis confirmed over-expression of MPO, CEBPA, CEBPB, GRN and IL8. We, therefore, evaluated the expression levels of miR-223, involved in myeloid differentiation: these cases had significantly higher levels of miR-223 than had the other cases of T-cell acute lymphoblastic leukemia, with values comparable to those observed in acute myeloid leukemia. Finally, these patients appear to have an unfavorable clinical course.
  
  
  CONCLUSIONS
  Using gene profiling we identified a subset of adult T-cell acute lymphoblastic leukemia, accounting for 10% of the cases analyzed, which displays myeloid features. These cases were not recognized by standard approaches, underlining the importance of gene profiling in identifying novel acute leukemia subsets. The recognition of this subgroup may have clinical, prognostic and therapeutic implications.
authors.affiliation: Division of Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy.
authors.forename: Sabina
authors.initials: S
authors.lastname: Chiaretti
authors.forename: Monica
authors.initials: M
authors.lastname: Messina
authors.forename: Simona
authors.initials: S
authors.lastname: Tavolaro
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Zardo
authors.forename: Loredana
authors.initials: L
authors.lastname: Elia
authors.forename: Antonella
authors.initials: A
authors.lastname: Vitale
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fatica
authors.forename: Paolo
authors.initials: P
authors.lastname: Gorello
authors.forename: Alfonso
authors.initials: A
authors.lastname: Piciocchi
authors.forename: Gina
authors.initials: G
authors.lastname: Scappucci
authors.forename: Irene
authors.initials: I
authors.lastname: Bozzoni
authors.forename: Claudio
authors.initials: C
authors.lastname: Fozza
authors.forename: Anna
authors.initials: A
authors.lastname: Candoni
authors.forename: Anna
authors.initials: A
authors.lastname: Guarini
authors.forename: Robin
authors.initials: R
authors.lastname: Foà
mesh_terms: D000328:Adult; D020869:Gene Expression Profiling; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000235:genetics*; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000235:genetics* / Q000473:pathology; D035683:MicroRNAs / Q000235:genetics*
chemical_list: D035683:MicroRNAs; C525067:MIR223, human