Pediatric acute leukemias: Identifying genes that relate to the
therapeutic prognosis
Neoplasm; Acute myeloid leukemia; Acute Lymphoblastic Leukemia; Computational Biology; Genetics.
Acute myeloid leukemia (AML) and acute lymphoid leukemia (ALL), neoplasms of the hematopoietic system, are hematological malignancies that affect adults and children, with great involvement in the latter. Analyzing these mutations allows for greater knowledge about drug resistance, complications arising from treatment, relapses and chances of cure - resulting in a better prognosis. Thus, the objective of this study was to analyze the gene expression, which is related to the therapeutic prognosis, in patients with acute myeloid and lymphoid leukemia. This is an observational, cross-sectional analytical study carried out in the pediatric oncology ward of Hospital Veredas with children, aged between 0 and 19 years old, diagnosed with leukemia. Previously, a patent was built aiming at the identification of genes related to prognosis, with regard to survival and recurrence of acute myeloid leukemias. Analysis for lymphoid subtype is ongoing. Subsequently, the evaluation of the biological material will allow the identification of the profile of the research participants. The S1PR4, PBX4, FAM171A1, RARRES2, HPGD, CD1C and PAM genes were identified in the pediatric patient group for both disease severity and negative association with AML survival. The FAM171A1, RARRES2 and PAM genes were identified in the analysis for chemoresistance. The sample, so far, consists of 13 patients, with a mean age of 7.83 years old (standard deviation of ± 7.7 years old), with 7 children (53.84%) being male. The mean time between the first symptoms and diagnosis was 55 days - the shortest and longest time, respectively: 7 and 180 days. The initial signs and symptoms, with the highest recurrence, that led to the search for a diagnosis were: pain in the lower limbs (30.76%) and pallor (23.07%). As for the type of leukemia, 10 (76.92%) patients were diagnosed with ALL, with type B being more prevalent (69.23%). No child had CNS infiltration, according to chart analysis. Spinal cord relapse was confirmed in 3 (23.07%) patients, who were on new anticancer treatment, with 2 (66.66%) of them waiting on the list for BMT. It is concluded that the knowledge of gene expression, in the sample obtained, will make it possible to present prognoses, resulting in possible improvements in the making of therapeutic decisions, regarding the treatment of pediatric leukemias.