title: Lymphoid enhancer binding factor-1 (LEF1) expression as a prognostic factor in adult acute promyelocytic leukemia.
abstract: Lymphoid enhancer-binding factor 1 (LEF1) is a downstream effector of the Wnt/ β-catenin signaling pathway. High LEF1 expression has been reported as a prognostic marker in hematologic malignancies. We evaluated the prognostic significance of LEF1 expression in 78 adult acute promyelocytic leukemia (APL) patients. APL samples were dichotomized at the median value and divided into: LEF1(low) and LEF1(high). LEF1(high) patients had lower WBC counts at baseline and were less likely to carry a FLT3-ITD than LEF1(low) patients. Early death occurred only in the LEF1(low) group. Moreover, LEF1(low) expression was associated with a high Sanz score. Survival analysis of 61 APL patients < 60 years revealed that the LEF1(high) group had a significantly longer overall survival (OS). Cox analysis for OS confirmed only LEF1 expression as an independent prognostic factor. Of the 17 patients over the age of 60, those in the LEF1(high) group showed a higher median survival. In silico analysis identified 9 differentially expressed, up-modulated genes associated with a high expression of LEF1; the majority of these genes is involved in the regulation of apoptosis. Our study provides evidence that LEF1 expression is an independent prognostic factor in APL, and could be used in patients risk stratification.
authors.affiliation: Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, Bari, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Albano
authors.forename: Antonella
authors.initials: A
authors.lastname: Zagaria
authors.forename: Luisa
authors.initials: L
authors.lastname: Anelli
authors.forename: Paola
authors.initials: P
authors.lastname: Orsini
authors.forename: Crescenzio Francesco
authors.initials: CF
authors.lastname: Minervini
authors.forename: Luciana
authors.initials: L
authors.lastname: Impera
authors.forename: Paola
authors.initials: P
authors.lastname: Casieri
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Coccaro
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Tota
authors.forename: Claudia
authors.initials: C
authors.lastname: Brunetti
authors.forename: Angela
authors.initials: A
authors.lastname: Minervini
authors.forename: Domenico
authors.initials: D
authors.lastname: Pastore
authors.forename: Paola
authors.initials: P
authors.lastname: Carluccio
authors.forename: Anna
authors.initials: A
authors.lastname: Mestice
authors.forename: Angelo
authors.initials: A
authors.lastname: Cellamare
authors.forename: Giorgina
authors.initials: G
authors.lastname: Specchia
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D014408:Biomarkers, Tumor / Q000096:biosynthesis / Q000235:genetics; D015331:Cohort Studies; D005260:Female; D015870:Gene Expression; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000235:genetics / Q000378:metabolism*; D051821:Lymphoid Enhancer-Binding Factor 1 / Q000096:biosynthesis* / Q000235:genetics / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016019:Survival Analysis; D060449:Wnt Signaling Pathway; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; C497573:LEF1 protein, human; D051821:Lymphoid Enhancer-Binding Factor 1