Hematology (Amsterdam, Netherlands) · 2025
DKK3 as a novel biomarker for risk stratification in pediatric acute lymphoblastic leukemia.
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Wang WenPeng, Zhu Feng, Li Pei, Chen YuYan, Mi DaWei, Guo Lei, Li Yan, Lu LiHui, Chang Ying, Gao JiZhao, Zhou Bi
Аннотация
INTRODUCTION: Aberrant Wnt signaling drives oncogenesis. DKK proteins, key extracellular regulators of Wnt pathway, play critical roles in tumor suppression or promotion.
METHODS: This study enrolled 66 newly diagnosed acute lymphoblastic leukemia (ALL) patients, stratified into low-risk (LR) and intermediate/high-risk (IR/HR) groups, alongside 39 children with immune thrombocytopenia (ITP) as controls. Bone marrow samples were collected at diagnosis and remission (day 46). DKK3 expression was measured using qRT - PCR and ELISA. Predictive performance was evaluated via ROC analysis and logistic regression.
RESULTS: DKK3 mRNA and protein levels were significantly lower at diagnosis than in remission and control groups (P < 0.001). LR patients showed higher DKK3 expression than IR/HR patients (P < 0.001). ROC analysis indicated that DKK3 mRNA and protein effectively predicted IR/HR status; combined AUC reached 0.889. No significant difference was found between B-ALL and T-ALL subgroups. Low DKK3 protein was an independent risk factor for event-free survival (P = 0.024).
CONCLUSION: DKK3 shows promise as a biomarker for early risk stratification and prognosis prediction in pediatric ALL, potentially supporting personalized treatment strategies.
METHODS: This study enrolled 66 newly diagnosed acute lymphoblastic leukemia (ALL) patients, stratified into low-risk (LR) and intermediate/high-risk (IR/HR) groups, alongside 39 children with immune thrombocytopenia (ITP) as controls. Bone marrow samples were collected at diagnosis and remission (day 46). DKK3 expression was measured using qRT - PCR and ELISA. Predictive performance was evaluated via ROC analysis and logistic regression.
RESULTS: DKK3 mRNA and protein levels were significantly lower at diagnosis than in remission and control groups (P < 0.001). LR patients showed higher DKK3 expression than IR/HR patients (P < 0.001). ROC analysis indicated that DKK3 mRNA and protein effectively predicted IR/HR status; combined AUC reached 0.889. No significant difference was found between B-ALL and T-ALL subgroups. Low DKK3 protein was an independent risk factor for event-free survival (P = 0.024).
CONCLUSION: DKK3 shows promise as a biomarker for early risk stratification and prognosis prediction in pediatric ALL, potentially supporting personalized treatment strategies.