CALCRL Gene is a Suitable Prognostic Factor in AML/ETO(+) AML Patients

INTRODUCTION: The t(8 ; 21) translocation is the most common chromosomal abnormality in human acute myeloid leukemia (AML) subtype 2 (M2), which forms the AML/ETO fusion gene. However, AML/ETO alone does not necessarily cause leukemia. Other factors are thought to contribute to the disease. Calcitonin receptor-like (CALCRL), a G-protein-coupled neuropeptide receptor, is involved in various biological processes, such as colony formation and drug resistance. METHODS: First, The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases were used to determine any differences in CALCRL expression in AML patients with and without AML/ETO and the prognostic significance of CALCRL expression in AML patients was further evaluated. Next, we detected the CALCRL expression level in 67 AML/ETO(+) AML patients and 16 patients with nonmalignant hematological diseases using qRT-PCR and identified its prognostic relevance. RESULTS: Individuals in the group expressing low levels of CALCRL had a longer median survival time. In AML/ETO(+) AML patients, higher mRNA levels of CALCRL were observed before treatment, which decreased after the complete remission that followed multiple chemotherapy sessions. Clinical features indicated that more patients in the CALCRL(high) group also had c-kit mutations compared with patients in other groups. Overall survival (OS) was longer in patients with lower levels of CALCRL expression, especially in patients with c-kit mutations or with more blast cells in bone marrow (BM). In addition, a longer OS was observed in the CALCRL(low) group after hematopoietic stem cell transplantation (HSCT). CONCLUSIONS: This preliminary study indicates that CALCRL could serve as a suitable prognostic factor in AML/ETO(+) AML patients.