Gene expression of CEBPA in Iraqi patients with acute myeloid leukemia

Abstract

Background. One of the most common genetic abnormalities in acute myeloid leukemia (AML) is mutations in the CCAAT enhancer binding protein alpha (CEBPA) gene. This gene codes for crucial transcription factors for differentiation and controlling the proliferation of myeloid precursors. Aim. To analyze the relative mRNA expression of CEBPA in AML patients and its correlation with clinical, morphological, cytogenetic, and gene mutation parameters among Iraqi patients for the first time. Methods.  Utilizing quantitative real-time polymerase chain reaction (RT-qPCR), the expression of the CEBPA gene was examined in the peripheral blood of 120 patients and 40 controls. The AML patients were characterized in terms of age, sex, FMS-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) and Nucleophosmin1 (NPM1) mutations, the French American British classification (FAB), and the World Health Organization (WHO). Results. The findings revealed that the expression levels of CEBPA were lower in patients compared to healthy controls, indicating gene downregulation. The expression was lower in females than males (p = 0.025) and decreased across disease stages. In addition, the FAB M1 type and WHO RUNX1T1/RUNX1 had the lowest CEBPA mRNA expression among the other types. The mutations of FLT3-ITD and NPM1 significantly affected CEBPA expression, with FLT3-ITD having the most pronounced effect (p = 0.029). Conclusion. The mRNA expression of the CEBPA gene was downregulated in patients with AML, especially in females and those with the FAB M1 type and the WHO RUNX1T1/RUNX1. Additionally, both FLT3 and NPM1 genes significantly influenced CEBPA expression.