Evaluation of serum level of lymphoid enhancer-binding factor-1 and its relation with clinico-hematological and prognostic parameters in pediatric patients with acute lymphoblastic leukemia

BACKGROUND: Acute lymphoblastic leukemia (ALL) is a heterogeneous disorder characterized by the proliferation of immature lymphoid cells that accumulate in the bone marrow, peripheral blood, and extramedullary sites, causing the clinical manifestations of the disease. Lymphoid enhancer-binding factor-1 (LEF1) is a target gene and central mediator for the Wingless-type signaling pathway, and it has an important role in normal hematopoiesis. High LEF1 expression was reported as a prognostic marker in many types of hematological and nonhematological malignancies. AIM OF THE STUDY: To evaluate the serum level of LEF1 in pediatric patients with ALL and its correlation with other hematological and clinical prognostic factors (white blood cells [WBC] count, age, gender, central nervous system involvement, and response to treatment). PATIENTS, MATERIALS, AND METHODS: This cross-sectional study was conducted on 60 children; 20 patients with newly diagnosed ALL before starting induction therapy, 20 patients with ALL during remission (postinduction), and 20 healthy controls. Measurement of serum LEF1 level was done by enzyme-linked immunosorbent assay. RESULTS: Serum level of LEF1 was higher in newly diagnosed patients than in either patients at remission or controls with highly significant differences. There is a significant positive correlation with total WBC count and no significant correlation between LEF1 level and other hematological and clinical parameters or with immunophenotypic subtypes. There was no significant correlation between LEF1 serum level and response to remission induction. CONCLUSION: A high serum concentration of LEF1 is found in newly diagnosed patients with ALL and showed a significant positive correlation with total WBC count.