Abstract
Background
Transcription factor SOX6 belongs to Sry‐related high‐mobility‐group box (SOX) family, has been reported to be downregulated and acts as a tumor-suppressor gene in various solid tumors, but in acute myeloid leukemia (AML) is incompletely understood.
Methods
The SOX6 expression was analyzed between AML patients and normal controls from public data and our research cohort. Correlations between SOX6 expression and clinical, genetic features together with survival were further analyzed.
Results
In both public and our present datasets, we demonstrated that SOX6 expression is notably downregulated in AML patients compared with normal controls. Moreover, the expression level of SOX6 was dynamic, along with the disease status. SOX6 was significantly decreased in relapsed/refractory AML compared with complete remission AML. Clinically, SOX6 underexpression was significantly correlated with bone marrow blasts, and WBC counts. Furthermore, decreased expression of SOX6 was more common in core binding factor AML (CBF-AML), rarely found in complex karyotype AML (CK-AML), and correlated with FLT3 mutations. By survival analyses, low-expression of SOX6 was associated with shorter overall survival (OS) and event-free survival (EFS) among cytogenetic normal AML (CN-AML) patients. Moreover, both univariate and multivariate analyses showed that low SOX6 expression was an independent unfavorable prognostic biomarker for CN-AML.
Conclusions
Our findings indicated that SOX6 underexpression, as a frequent event in AML, was associated with genetic abnormalities and prognosis in AML. SOX6 might be a valuable biomarker for risk stratification, predicting prognosis and relapse of AML.
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Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Abbreviations
- AML:
-
Acute myeloid leukemia
- SOX:
-
Sry‐related high‐mobility‐group box
- GEPIA:
-
Gene expression profiling interactive analysis
- GEO:
-
Gene expression omnibus
- TCGA:
-
The cancer genome atlas
- WHO:
-
World Health Organization
- FAB:
-
French–American–British
- CR:
-
Complete remission
- BM:
-
Bone marrow
- RT-qPCR:
-
Quantitative reverse transcription polymerase chain reaction
- EFS:
-
Event-free survival
- OS:
-
Overall survival
- CN-AML:
-
Cytogenetically normal AML
- CBF-AML:
-
Core binding factor AML
- CK-AML:
-
Complex karyotype AML
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HS and YL designed the project; DJ and HS performed experiments; HS analyzed data and wrote the manuscript; QZ, EL, DJ and YL performed revised the manuscript. All authors reviewed the manuscript. All authors read and approved the final manuscript.
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This study was approved by the Ethics Committee of The Third Xiangya Hospital of the Central South University. The study was conducted in accordance with the principles of the Declaration of Helsinki.
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Li, Y., Jiang, D., Zhang, Q. et al. Clinical implications and genetical insights of SOX6 expression in acute myeloid leukemia. J Cancer Res Clin Oncol 149, 4443–4453 (2023). https://doi.org/10.1007/s00432-022-04349-8
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DOI: https://doi.org/10.1007/s00432-022-04349-8