CircRNA-KRAS in bone marrow mononuclear cells of patients with acute myeloid leukemia
Objective To observe the changes of circRNA-KRAS in bone marrow mononuclear cells of patients with acute myeloid leukemia(AML),and to explore its relationships with the clinicopathologic features and prognosis of AML patients.Methods From January 2014 to January 2016,128 AML patients(AML group)were diagnosed and treated in the Affiliated People's Hospital of Jiangsu University,and another 30 patients receiving bone marrow examination due to non-hematological diseases at the same period were included as control group.The relative expression of circRNA-KRAS in bone marrow mononuclear cells was detected by real-time fluorescence quantitative PCR in two groups.Spearman's correlation coefficient was used to analyze the correlation between circRNA-KRAS and blood platelet count.ROC curves were plotted to evaluate the efficiency of circRNA-KRAS on diagnosing AML.All AML patients were given standardized protocol chemotherapy.According to the optimal cut-off value of circRNA-KRAS on diagnosing AML,128 AML patients were divided into high expression group and low expression group,and the gender,age,white blood cell count,hemoglobin,platelet count,proportion of blasts in bone marrow,FAB classification,chromosome classification,and overall response rate after chemotherapy induction were compared between two groups.The follow up was conducted till May 2023,and the disease-free survival and overall survival were compared between high and low expression groups.Results The relative expression of circRNA-KRAS was higher in control group[0.163 5(0,1.000 0)]than that in AML group[0.008 3(0,0.846 2)(U=1.694,P=0.003).The platelet count of 128 AML patients was 46.5×109/L(19.0 × 109/L,78.5 × 109/L),and circRNA-KRAS was positively correlated with platelet count(r=0.237,P=0.029).When using the optimal cut-off value of circRNA-KRAS of 0.056 3,the AUC for diagnosing AML was 0.846(95％CI:0.767-0.925,P=0.007),the sensitivity was 83.3％,and the specificity was 77.3％.In 128 AML patients,circRNA-KRAS was ≥0.056 3 in 29 patients(high expression group)and was＜0.056 3 in 99 patients(low expression group).The platelet count was lower in low expression group[30.0X 109/L(19.0× 109/L,57.0× 109/L)than that in high expression group[48.0× 109/L(27.0× 109/L,78.5× 109/L)](U=1.054,P=0.029),and there were no significant differences in the gender ratio,age,white blood cell count,hemoglobin,proportion of blasts in bone marrow,FAB classification,chromosome classification,and overall response rate after chemotherapy induction between two groups(P＞0.05).The median follow-up lasted for 42 months,8 patients in high expression group and 19 in low expression group were lost.There were no significant differences in the disease-free survival time[22.0(5.0,57.0)months vs.23.0(8.0,44.0)months]and the overall survival time[32.0(14.5,73.5)months vs.25.5(12.0,48.0)months]between high and low expression groups(x2=0.527,P=0.468;x2=1.421,P=0.233).Conclusion The downregulation of circRNA-KRAS expression in bone marrow mononuclear cells of AML patients contributes to the diagnosis of AML.
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