Study of telomere-associated molecular markers in pediatric patients with Acute Lymphoblastic Leukemia (B-ALL).
Telomere, hTERT, B Acute lymphoblastic leukemia and relapse
Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy, representing more than 20% of pediatric cancers. ALL derived from B-cells (B-ALL) typify the majority of cases in patients under 18 years old that are related with different genetic profiles. Telomeres and telomerase are associated with genetic modifications and cell proliferation which makes them attractive targets for studies in leukemia. In this sense the aim of this work was determine the role of molecular markers associated with telomeres and telomerase, especially their potential as an indicator of therapeutic response in childhood ALL and set up the potential of telomerase as a pharmacological target in B-ALL. Analyzing 79 cases of childhood B-ALL we identified that high telomerase expression was associated with several markers such as age, weight, size, body index, minimum residual disease (MRD) of 79 days and relapse. In this sense these associations are complementary for establish the role of telomerase on patient relapse. From these data, we hypothesized that high telomerase expression cold be related to drug resistance. In a vitro approach, 3 of 4 lineages (NALM-6, 697, RS4;11), after transfection to show downregulation of telomerase, had increased sensitivity to doxorubicin, what fortify the hypothesis that the high expression of telomerase influences the patient treatment, increasing chance to relapse. Therefore telomerase have been proven to be promising pharmacological target as well as combined therapy with telomerase inhibitors may be an alternative strategy for B-ALL