maryam sheikhi - Msc. Cancer Molecular Pathology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
hossein ayatollahi - MD, Cancer Molecular Pathology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
arezoo Shajiee - Msc. Cancer Molecular Pathology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Mohammad Hadi Sadeghian - MD, Associate professor of pathology, Department of Hematology and Blood Bank, Cancer Molecular Pathology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Background & Objectives: Acute myeloid leukemia (AML) is a malignant disorder involving blood cells, characterized by obstructed or distorted differentiation of hematopoietic stem cells. In cytogenetically normal AML (CN‑AML), molecular abnormalities in NPM, FLT3, CEBPA and BAALC gene are observed. Initially, high BAALC expression was introduced in a study on AML cases with trisomy 8. In the present systematic review, we aimed to determine the prognostic value of BAALC expression in CN-AML patients within the age range of 1 month to 15 years. Materials and Methods: In this systematic review, scientific databases including PubMed, Scopus, Embase, ISI and Cochrane Library were searched. All the evaluated retrospective studies focused on the prognostic value of BAALC expression.Results: Overall, BAALC expression was reported in 30-60% of AML patients (mean=45%). High expression of BAALC gene was reported in M0, M1 and M2 subtypes. In only one study, in addition to these subtypes, M4 was reported (12.5% of cases). Conclusion: As the results indicated, high BAALC expression was a poor prognostic marker for remission success, therapy, relapse or death in pediatric AML. In this systematic review, high BAALC expression was significantly associated with poor response to chemotherapy in pediatric AML. However, OS and EFS findings were contradictory; also, BAALC expression increased with relapse and death in these patients. Therefore, BAALC expression could be considered as a clinical prognostic marker for the treatment of AML patients. Further efficient prognostic indicators should be identified in order to gather information about therapeutic strategies for AML and risk analysis in these patients.

BAALC, Expression, Pediatric AML and Prognosis