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Subject Area

Clinical Pathology

Article Type

Original Study

Abstract

Background Several studies have highlighted long noncoding RNA growth-arrest-specific 5 (GAS5) as a key player in various normal and pathological conditions. Overall, GAS5 acts as a tumor suppressor, whose downregulation is directly connected to tumor proliferation, tumor progression, and therapy-related resistance across different types of tumors. To date, its importance in acute leukemia has not been widely investigated. Objectives To investigate the changes in the expression levels of long noncoding RNA GAS5 during induction chemotherapy of adult patients with B-cell acute lymphoblastic leukemia (B-ALL). Patients and methods Peripheral blood samples were obtained before starting therapy from 35 adult patients with B-ALL and then on day 15 and day 33 of induction therapy. Twenty control samples were collected from healthy donors. GAS5 expression was estimated using reverse-transcription quantitative PCR technique. Results Pretreatment GAS5 expression of B-ALL patients was significantly decreased when compared with that of healthy controls (P = 0.002). Analysis demonstrated that GAS5 expression was significantly increased on day 15 as compared with its level at diagnosis (P < 0.001). On day 33, GAS5 expression was significantly increased in comparison with its level on day 15 (P < 0.001). Moreover, our results showed that low GAS5-expression levels at diagnosis were significantly associated with initial leukocyte count more than 30 × 103/μl and BCR–ABL1-positive B-ALL (P = 0.01, P = 0.015, respectively). Conclusions We reported a downregulation of circulating GAS5 in B-ALL patients, which showed elevation after initiation of induction therapy. Downregulation of GAS5 was associated with unfavorable prognostic factors, denoting its prognostic potential in B-ALL.

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