Prognostic role of ACTL10 in Cytogenetic Normal Acute Myeloid Leukemia

Abstract

ACTL10 is a member of the actin family; however, despite previous studies suggesting that certain proteins in this family may be related to the pathogenesis of leukemia, to the best of our knowledge, no studies to date have demonstrated any association between ACTAL10 and leukemia. Thus, the present study aimed to determine the association between ACTL10 expression levels, DNA methylation levels and the clinical prognosis in cytogenic normal acute myeloid leukemia (CN-AML). Data from seventy-five patients with CN-AML and patients with AML treated with chemotherapy or allogeneic hematopoietic stem cell transplantation were obtained from The Cancer Genome Atlas (TCGA) dataset and were used to analyze the clinical prognosis of ACTL10 RNA expression levels and DNA methylation levels. In addition, the study also investigated the combined clinical prognosis of ACTL10 RNA expression levels and ACTL10 DNA methylation levels in 74 patients with CN-AML from the TCGA dataset. ACTL10 RNA expression levels were observed to be highly expressed in patients with CD34⁺/CD38⁺ AML (P<0.01). Both ACTL10 RNA expression levels and DNA methylation were found to be independent prognostic factors for patients with CN-AML; patients with CN-AML in the ACTL10 RNA-high expression group had an increased EFS (P=0.0016) and OS (P=0.014) and patients in ACTL10 DNA methylation-low group also demonstrated a long EFS (P<0.0001) and OS (P=0.004). Notably, integrating ACTL10 RNA expression levels and ACTL10 DNA methylation levels could more accurately predict the prognosis of patients with CN-AML (EFS and OS, P<0.0001). In conclusion, the findings of the present study suggested that the high RNA expression levels and low DNA methylation levels of ACTL10 may predict a good prognosis in patients with CN-AML.

Keywords: ACTL10; CN-AML; DNA methylation; RNA expression.

Figure 1

EFS and OS between the ACTL10 RNA-high expression group and the ACTL10 RNA-low expression group in patients with CN-AML. Left side: the x-axis represents the EFS time (months) and the y-axis represents the survival probability. Right side: the x-axis represents the OS time (months) and the y-axis represents the survival probability. All data was obtained from the TCGA dataset. (A) Data from 75 patients with CN-AML (training cohort). (B) Data from 92 patients with AML who received chemotherapy. Data were analyzed using a log-rank test. EFS, event-free survival time; OS, overall survival time.

Figure 2

EFS and OS between the ACTL10 DNA methylation-high group and the ACTL10 DNA methylation-low group were compared in patients with CN-AML. Left side: the x-axis represents the EFS time (months) and the y-axis represents the survival probability. Right side: the x-axis represents the OS time (months) and the y-axis represents the survival probability. All data was obtained from the TCGA dataset. (A) Survival curve for 85 patients with CN-AML. (B) Survival curve for 77 patients with AML who received allogeneic hematopoietic stem cell transplantation. (C) Survival curve for patients with AML who received chemotherapy. Left side: EFS was analyzed in 98 patients with AML who received chemotherapy. Right side: OS was analyzed in 101 patients with AML who received chemotherapy. Data were analyzed using a log-rank test. EFS, event-free survival time; OS, overall survival time.

Figure 3

Integration of ACTL10 RNA expression levels and ACTL10 DNA methylation levels to predict survival time. Left side: the x-axis represents the EFS time (months) and the y-axis represents the survival probability. Right side: the x-axis represents the OS time (months) and the y-axis represents the survival probability. Data was analyzed from 74 patients with CN-AML from the TCGA dataset. G1 represents patients with high expression levels of ACTL10 RNA and high methylation levels of ACTL10 DNA; G2 represents patients with high expression levels of ACTL10 RNA and low methylation levels of ACTL10 DNA; G3 represents patients with low expression levels of ACTL10 RNA and high methylation levels of ACTL10 DNA; G4 represents patients with low expression levels of ACTL10 RNA and low methylation levels of ACTL10 DNA. Data were analyzed using a log-rank test. EFS, event-free survival time; OS, overall survival time.