Study of transcription factor CCAAT/enhancer binding protein-α (C/EBP_α) in adult patients with acute lymphoblastic leukemia

Background:Leukemic stem cells have self-renewal property. Identification of genes or signaling pathways involved in self-renewal of leukemic stem cells will promote the development of more effective treatment for acute leukemias.Objectives: To assess the prognostic significance of the CCAATT/enhancer binding protein-α (C/EBPα) transcription factor in primary adult patients with acute lymphoblastic leukemia (ALL) and its correlation to prognosis and response to therapy.Participants and methods: Forty adult patients with ALL (23 pre-B ALL, one pro-B ALL, four mature B ALL, and 12 T ALL) were recruited from the Hematology Department, Ain Shams University, compared with 25 age-matched and sex-matched healthy controls. All patients were subjected to a complete blood count, blood chemistry, bone marrow (BM) examination, immunophenotyping, cytogenetics, and assessment of the C/EBPα level using real–time PCR at presentation and at D28 of treatment. Patients were followed over a period of 24 months (1–24 ms).Results: Compared with controls, patients with ALL at presentation and at follow-up showed a highly significant difference in C/EBPα (P 0.01), whereas there was no significant difference between B ALL and T ALL. Patients who achieved remission showed a significant increase in C/EBPα after treatment. There was no significant correlation between C/EPBα and other prognostic factors in ALL, except with the Philadelphia chromosome; there was a significantly negative correlation at diagnosis and at follow-up.Conclusion: Deficient C/EBPα among patients with ALL may contribute toward its pathogenesis and remission is associated with a significant increase in the C/EBPα level. C/EBPα is an independent prognostic factor and its measurement helps to predict response and contributes significantly toward better management decisions.