Background
Leukemia stem cell (LSC)-enriched genes have been shown to be highly prognostic in acute myeloid leukemia (AML). However, the prognostic value of tumor suppressor genes (TSGs) that are repressed early in LSC remains largely unknown.
Methods
We compared the public available expression/methylation profiling data of LSCs with that of hematopoietic stem cells (HSCs), in order to identify potential tumor suppressor genes in LSC. The prognostic relevance of
PCDH17
was analyzed on a cohort of 173 AML patients from The Cancer Genome Atlas (TCGA), and further validated in three independent cohorts (n = 339).
Results
We identified protocadherin17 (
PCDH17
) and demonstrated that it was significantly down-regulated and hypermethylated in LSCs compared with HSCs. Our analyses of primary AML patient samples also confirmed these deregulations. Clinically, low
PCDH17
expression was associated with female sex (
P
= 0.01), higher WBC (
P
< 0.0001), higher percentages of blasts in bone marrow (BM) and peripheral blood (PB) (
P
= 0.04 and < 0.001, respectively), presence of
FLT3
-internal tandem duplications (
P
= 0.002), mutated
NPM1
(
P
= 0.02), and wild-type
TP53
(
P
= 0.005). Moreover, low
PCDH17
expression predicted worse overall survival (OS) in four independent cohorts as well as in the molecularly defined subgroups of AML patients. In multivariable analyses, low
PCDH17
expression retained independent prognostic value for OS. Biologically,
PCDH17
expression-associated gene signatures were characterized by deregulations of EMT- and Wnt pathway-related genes.
Conclusions
PCDH17
gene was silenced by DNA methylation in AML. Low
PCDH17
expression is associated with distinct clinical and biological features and improves risk stratification in patients with AML.
Electronic supplementary material
The online version of this article (10.1186/s12967-019-1851-1) contains supplementary material, which is available to authorized users.