CRLF2 and IKZF1 Expression in Egyptian Acute Lymphoblastic Leukemia Patients

Objective Overexpression of cytokine receptor-like factor 2 (CRLF2) caused by different genetic aberrations has been detected in ALL and is linked to poor outcome. The majority of cases having high CRLF2 expression are clustered in the Philadelphia-like (Ph-like) ALL subgroup. Furthermore, Ph-like ALL is accompanied by alterations of the IKZF1 gene, encoding the transcription factor Ikaros. Thus, it was important to recognize and identify these cases at presentation. Materials and Methods We investigated clinical characteristics and the prognostic significance of mRNA expression levels of CRLF2 and IKZF1 alterations in a group of Egyptian patients with ALL. Peripheral blood samples from 34 newly diagnosed ALL cases, together with 14 healthy controls, were assessed for CRLF2 and IKZF1 expression by qRT-PCR. Results CRLF2 mRNA level showed significant overexpression in ALL patients in comparison to healthy controls (P = 0.038). Overall survival was shorter among B-ALL patients, with high CRLF2 (6.1 months versus 19.4 months, respectively, P=0.04). Moreover, patients with low IKZF1 exhibited significantly higher total leucocytic counts and lower platelet counts (P 0.038 and 0.044, respectively). Conclusion High CRLF2 expression was linked to poor survival among B-ALL cases. Identification of Ph-like ALL should be recognized as a distinct, high-risk entity, and future research on improving diagnostic and therapeutic approaches is required in our locality.