Identification of Heme Oxygenase-1 as a Novel Predictor of Hematopoietic Stem Cell Transplantation Outcomes in Acute Leukemia.
OBJECTIVE
The main aim of this study was to determine the correlation between clinical outcome and heme oxygenase-1 (HO-1) expression before and after hematopoietic stem cell transplantation (HSCT) in acute leukemia.


METHODS
HO-1 mRNA levels in 83 patients were measured using qRT-PCR. In a comparative analysis of HO-1 levels in relation to different post-transplant outcomes, the HO-1 threshold, determined via the receiver operating characteristic (ROC) curve, was effectively used to predict clinical relapse and acute graft-versus-host disease (aGVHD). The correlations among clinical relapse, aGVHD and HO-1 expression were analyzed based on this threshold.


RESULTS
Leukemia risk stratification and relative expression of HO-1 before pretreatment had significant effects on clinical relapse. Leukemia risk stratification, relative expression of HO-1 after HSCT and the interval from diagnosis to transplantation had a significant influence on aGVHD. Both relapse and aGVHD appeared to be associated with relative HO-1 expression. The relative expression rate of HO-1 was 1.131-1.186 before pretreatment, and strongly associated with post-transplantation relapse. The relative expression rate of HO-1 was 1.102-1.144 after transplantation, and closely related to aGVHD. ROC curve analysis revealed high specificity and sensitivity of HO-1 expression in predicting relapse and aGVHD after allo-HSCT.


CONCLUSIONS
HO-1 expression can be effectively used as a predictor of relapse as well as a diagnostic factor of aGVHD after transplantation for allo-HSCT patients with acute leukemia.
Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis under Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou, China.
Yinghao
Y
Lu
Depei
D
Wu
Jishi
J
Wang
Yan
Y
Li
Dan
D
Ma
Xiao
X
Chai
Qian
Q
Kang
D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D001853:Bone Marrow / Q000201:enzymology / Q000473:pathology; D002648:Child; D005260:Female; D015870:Gene Expression; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D018380:Hematopoietic Stem Cell Transplantation; D051547:Heme Oxygenase-1 / Q000235:genetics* / Q000378:metabolism; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000201:enzymology / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000201:enzymology / Q000235:genetics / Q000473:pathology; D011379:Prognosis; D012333:RNA, Messenger / Q000235:genetics* / Q000378:metabolism; D012372:ROC Curve; D012008:Recurrence; D035781:Siblings; D061665:Time-to-Treatment; D014184:Transplantation, Homologous; D061349:Unrelated Donors
D015415:Biomarkers; D012333:RNA, Messenger; C496541:HMOX1 protein, human; D051547:Heme Oxygenase-1