IKAROS Gene Deleted B-Cell Acute Lymphoblastic Leukemia in Mexican Mestizos: Observations in Seven Patients and a Short Review of the Literature.
BACKGROUND
In B-cell acute lymphoblastic leukemia, one of the most frequent cytogenetic alterations is the presence of the Philadelphia chromosome. Recently, newly identified genetic alterations have been studied, among them the IKZF1 deletion. IKZF1 encodes IKAROS, a zinc finger protein that plays an important role in hematopoiesis involving the regulation process of adhesion, cellular migration, and as a tumor suppressor.


OBJECTIVE
We aimed to study the impact of IKAROS deletion in the evolution and prognosis of B-cell acute lymphoblastic leukemia.


METHODS
At a single center we prospectively studied patients diagnosed with B-cell acute lymphoblastic leukemia and screened for IKZF1 deletion using the multiplex ligation-dependent probe amplification method. We did a descriptive analysis of patients positive for the IKZF1 deletion to determine its impact on the evolution of the disease and survival rate.


RESULTS
Between 2010 and 2015, 16 Mexican mestizo patients with B-cell acute lymphoblastic leukemia were prospectively screened for IKZF1 deletion; seven (43%) were positive and were included for further analysis. The age range of patients was 13-60 years; six were males and one female. All cases had type B acute lymphoblastic leukemia. Of the seven patients, two died, three were lost to follow-up, and two continue in complete remission with treatment. Results are worse than those in a group of patients with non-mutated IKAROS B-cell acute lymphoblastic leukemia previously studied in our center.


CONCLUSIONS
Although this is a small sample, the presence of IKAROS deletion in acute lymphoblastic leukemia patients could represent a poor-prognosis marker and was probably related to therapy failure. It is also possible that this variant of leukemia may be more prevalent in Mexico. More studies are needed to define the role of IKZF1 deletion in acute lymphoblastic leukemia and the real prevalence of the disease in different populations.
Centro de Hematología y Medicina Interna de Puebla, Puebla, Mexico.|Universidad de las Américas Puebla, Puebla, Mexico.|Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico.
Guillermo José
GJ
Ruiz-Delgado
Centro de Hematología y Medicina Interna de Puebla, Puebla, Mexico.|Universidad de las Américas Puebla, Puebla, Mexico.
Yahveth
Y
Cantero-Fortiz
Centro de Hematología y Medicina Interna de Puebla, Puebla, Mexico.|Benemérita Universidad Autónoma de Puebla, Puebla, Mexico.
Andrés Aurelio
AA
León-Peña
Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico.
Mónica
M
León-González
Centro de Hematología y Medicina Interna de Puebla, Puebla, Mexico.|Benemérita Universidad Autónoma de Puebla, Puebla, Mexico.
Ana Karen
AK
Nuñez-Cortés
Centro de Hematología y Medicina Interna de Puebla, Puebla, Mexico.|Universidad de las Américas Puebla, Puebla, Mexico.|Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico.
Guillermo José
GJ
Ruiz-Argüelles
D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D017353:Gene Deletion; D006801:Humans; D051740:Ikaros Transcription Factor / Q000235:genetics*; D007198:Indians, North American / Q000235:genetics; D008297:Male; D008800:Mexico; D008875:Middle Aged; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D055815:Young Adult
C497239:IKZF1 protein, human; D051740:Ikaros Transcription Factor