Elevated expression levels of ETS2 were a strong predictor of prognosis in acute myeloid leukemia (AML) and should be used to guide treatment decisions, according to recent research published in Journal of Translational Medicine (online July 19, 2017; doi:10.1186/s12967-017-1260-2).
-----
Related Content
Adding Androgens to Maintenance Therapy Improves Survival in Older Patients With AML
Unrealistic expectations may hinder blood cancer patients' care
-----
Due to widely different treatment outcomes observed in patients with AML, identifying effective prognostic biomarkers is of urgent clinical need. Multiple prognostic markers have been established, including mutations in NPM1, CEBPA, and FLT3-ITD. ETS2 is a downstream effector for the RAS/RAF/ERK pathway, which is instrumental in the development on AML tumors. However, the clinical impact and prognostic implications of ETS2 expression in AML remains unidentified.
A group of Chinese researchers led by Xiaoyan Ke, department of hematology, Lymphoma Research Center, Peking University, conducted a study to assess the prognostic relevance of ETS2 expression among two cohorts of patients with AML. The first cohort evaluated ETS2 expression among patients who received chemotherapy alone (n = 100) or chemotherapy with allogeneic hematopoietic cell transplantation (HCT; n = 72). The second cohort consisted of 329 patients. Primary endpoints of the study included overall survival (OS), event-free survival (EFS), and relapse-free survival (RFS).
After reviewing the first cohort, researchers determined that high expression of ETS2 was associated with shorter OS, EFS, RFS, and increased adverse events in both the chemotherapy and allogeneic HCT groups. Among patients with high ETS2 expression, those who received allogeneic HCT (n = 39) demonstrated longer OS, EFS, and RFS compared with those who received chemotherapy alone (n = 47). Treatment modality did not factor into survival rates for patients with low ETS2 expression.
Similar adverse events were observed in the second AML cohort.
Additional analysis of microRNA genome-wide profiles revealed 145 microRNAs strongly associated with ETS2 expression.
Researchers concluded that high expression of ETS2 should be considered a poor prognostic factor in AML and may guide treatment decisions toward allogeneic HCT. Furthermore, “distinctive gene/microRNA expression profiles associated with ETS2 expression may explain the role of ETS2 in the leukemogenic process,” they wrote.—Zachary Bessette
