S1PR3 expression independently predicts the cumulative incidence of relapse in adult B-cell acute lymphoblastic leukemia: a single-center retrospective analysis.

OBJECTIVES

This study aims to investigate the predictive value of S1PR3 for the 3-year cumulative incidence of relapse (CIR) in adult patients with B-cell acute lymphoblastic leukemia (B-ALL).

METHODS

This retrospective study enrolled 285 adult patients with B-ALL and 13 healthy controls from January 2019 through January 2022. S1PR3 expression was analyzed in leukemia cell lines and peripheral blood mononuclear cells (MCs) using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and Western blot. S1PR3 expression in bone marrow MCs was also measured by RT-qPCR. Predictive value was assessed using receiver operating characteristic curve analysis. Spearman correlation analysis was performed for correlation studies. Kaplan-Meier curves were employed for survival analysis. Cox regression was conducted for risk factor analysis.

RESULTS

S1PR3 was upregulated in leukemia cell lines and B-ALL patient MCs compared with controls (P < .001). Relapsed patients demonstrated elevated S1PR3 levels compared with nonrelapsed patients (P < .001). S1PR3 expression predicted B-ALL relapse with an area under the curve of 0.887. Patients with high S1PR3 had a significantly higher relapse rate than those with low S1PR3 (P < .001). S1PR3 expression was closely associated with clinicopathologic characteristics. High S1PR3 expression was associated with a leftward shift in Kaplan-Meier curves and significantly increased CIR in patients (P < .001). High S1PR3 expression was an independent risk factor for relapse within 3 years in patients with B-ALL (P < .05).

CONCLUSIONS

Elevated S1PR3 expression is an independent predictor of relapse in adult B-ALL, providing a novel biomarker to enhance risk stratification and guide potential targeted interventions.