International Journal of Hematology-Oncology and Stem Cell Research 2018. 12(1):49-56.

Association between (GT)n Repeats in Heme Oxygenase-1 Gene Promoter and 3-Year Survival of Patients with Acute Leukemia: A Controlled, Cross-Sectional Study
Mohammad Kazemi, Farinaz Khosravian, Amir Abbas Sameti, Alireza Moafi, Mohammad Reza Merasi, Mansour Salehi, Majid Nejati, Mohaddeseh Behjati


Background: Acute leukemia is a common pediatric cancer. Novel strategies for treatment of acute leukemia have been developed, but treatment resistance has remained as the most problematic issue. It is hypothesized that the HO-1 gene up-regulation is responsible for tumor resistance to chemotherapy or radiotherapy-induced apoptosis. HO-1 expression levels have been related to (GT)n microsatellite polymorphisms in the location of its promoter.This study designed to compare allelic frequencies of (GT)n microsatellite polymorphisms in HO-1 gene between acute leukemia patients and healthy controls. Indeed, 3-year disease-free survival was also evaluated.

Materials and Methods: The study included 63 acute leukemia patients and 70 healthy infants. We used patient’s medical records to collect data regarding the post-chemotherapy survival. The number of GT repeats in HO-1 promoter was determined by an ABI 3100 sequencer.

Results: The HO-1 GT repeats ranged from 14 to 34 with peaks at 27 repeats in both cases and controls. Children with longer alleles ((GT)n ≥ 27) had enhanced 3-year survival rate after treatment with chemotherapy or radiotherapy (P<0.05).

Conclusion: Although no significant differences were observed between leukemia patients and controls regarding allelic frequency, we found elevated frequency of “LL” genotype in leukemia patients with good 3-year surveillance. Radiotherapy and chemotherapy might elevate the expression levels of HO-1 with subsequent increased resistance of leukemia patients to therapy.



Acute leukemia, 3-year survival, GT repeats, Heme oxygenase-1 gene promoter

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