Cryptochrome -1 Gene Expression is a Reliable Prognostic Indicator in Egyptian Patients with Chronic Lymphocytic Leukemia: A Prospective Cohort Study

• Published in: Turkish journal of haematology 2018, Vol.35 (3), p.168-174
• Main Authors: Habashy, Deena Mohamed, Eissa, Deena Samir, Aboelez, Mona Mahmoud
• Format: Article
• Language: English
• Subjects: Anemia; Cancer; cd38; Cell cycle; Cell growth; chronic lymphocytic leukemia; circadian genes; Circadian rhythm; Cohort analysis; cryptochrome-1; Epigenetics; Gene expression; Immunoglobulins; Leukemia; Lymphocyte receptors; Medical prognosis; Polymerase chain reaction; prognosis; real-time polymerase chain reaction; time to first treatment; Tıp; zap-70
• ISSN: 1300-7777; 1308-5263
• DOI: 10.4274/tjh.2017.0169

Traditional prognostic factors have proved insufficient to account for heterogeneity in the clinical behavior of chronic lymphocytic leukemia (CLL).  -1 ( ) is a circadian clock gene essential in maintaining the circadian rhythm and regulating cell proliferation. We evaluated   gene expression in CLL and addressed its putative role as a prognostic indicator for the clinical course of CLL. A total of 100 CLL patients at diagnosis were studied for   gene expression by real-time reverse-transcription polymerase chain reaction and were followed for assessment of time to first treatment (TFT).  was expressed in 94% of the CLL patients at diagnosis. The median   relative gene expression level (0.006) stratified patients into high and low expression groups. Forty of 100 (40%) CLL patients showed high  , 54/100 (54%) showed low  , and 6/100 (6%) had undetectable   gene expression. High   gene expression was concordant with CD38 , Zap-70 , and double CD38 Zap-70 expression; unfavorable/intermediate cytogenetics; unmutated  gene; and diffuse marrow infiltration. The high  gene expression patient group exhibited shorter TFT than the patients with low   gene expression. A Cox proportional hazard regression model identified   gene expression to be independently predictive for TFT.  is differentially expressed among CLL patients, stratifying them into low-risk and high-risk groups.   gene expression could constitute a reliable prognostic indicator for CLL progression, complementing the role of standard well-established prognostic factors.   gene expression could be employed as a prognostic indicator for disease progression during the initial prognostic work-up and follow-up for CLL patients.