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Positive expression of PAX7 indicates poor prognosis of pediatric and adolescent AML patients
Tianyou Yan1, Duolan Naren1, Yuping Gong1
1Department of Hematology, West China Hospital, Sichuan University, Chengdu, China.
Insights
Detecting PAX7 gene expression in pediatric acute myeloid leukemia (AML) can predict relapse risk. Positive PAX7 indicates a poorer prognosis, aiding in risk stratification for better treatment strategies.
Area of Science:
- Pediatric Oncology
- Molecular Biology
- Hematologic Malignancies
Background:
- Therapeutic advances have improved childhood acute myeloid leukemia (AML) outcomes.
- Relapse remains a significant challenge, affecting approximately half of cases.
- Accurate risk stratification is crucial for predicting relapse potential.
Purpose of the Study:
- To investigate the prognostic value of PAX7 gene expression in pediatric and adolescent AML.
- To determine if PAX7 expression can improve risk stratification for AML patients.
Main Methods:
- Utilized RNA-sequencing data from The Cancer Genome Atlas (TARGET-AML).
- Analyzed clinical information of 156 pediatric and adolescent AML patients.
- Correlated PAX7 expression profiles with overall survival (OS) and event-free survival (EFS).
Main Results:
- Positive PAX7 expression was associated with shorter OS and EFS, particularly in patients over 14 years old.
- PAX7 positivity predicted worse outcomes in intermediate- and low-risk groups.
- Allogeneic hematopoietic stem cell transplantation (allo-HSCT) in first complete remission improved outcomes.
Conclusions:
- PAX7 expression serves as a significant indicator of poor prognosis in pediatric and adolescent AML.
- PAX7 detection aids in refining risk stratification for intermediate- and low-risk AML patient groups.
Abstract:
Objective: Therapeutic advances based on risk stratification and implementation of excellent supportive care measures have significantly improved outcomes for childhood acute myeloid leukemia (AML) over the past 30 years. However, approximately half of all childhood AML cases relapse. Therefore, precise risk stratification is needed for predicting relapse potential.Methods: RNA-seq data of TARGET-AML and corresponding clinical information of pediatric and adolescent AML cases were downloaded from The Cancer Genome Atlas. Clinical information of 156 patients with gene expression data was extracted. The effects of PAX7 expression profiles on overall survival (OS) and event-free survival (EFS) were analyzed.Results: Positive expression of PAX7 indicated shorter OS and EFS, especially in patients older than 14 years. Furthermore, positive PAX7 expression also predicted shorter OS and EFS in intermediate- and low-risk group patients, compared to patients with negative PAX7 expression. In addition, patients who have received allogenic hematopoietic stem cell transplantation (allo-HSCT) in the first complete remission had better outcome than those who did not receive HSCT.Conclusions: Positive PAX7 expression in pediatric and adolescent AML patients indicates a poor outcome. Hence, the detection of PAX7 expression profiles is helpful for further stratification of intermediate- and low-risk groups.
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