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Low BACH2 expression predicts adverse outcome in chronic lymphocytic leukaemia

Lookup NU author(s): Dr Carmela Ciardullo, Dr Katarzyna SzoltysekORCiD, Dr Peixun Zhou, Dr Elaine WillmoreORCiD, Dr Amir EnshaeiORCiD, Dr Anna Walaszczyk, Jia Yee Ho, Dr Vikki Rand, Dr Scott Marshall, Dr Andrew Hall, Professor Christine Harrison FRCPath FMedSci, Dr Meera Soundararajan, Dr Jeyanthy Eswaran



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2021 by the authors. Licensee MDPI, Basel, Switzerland. Chronic lymphocytic leukaemia (CLL) is a heterogeneous disease with a highly variable clinical outcome. There are well‐established CLL prognostic biomarkers that have transformed treatment and improved the understanding of CLL biology. Here, we have studied the clinical significance of two crucial B cell regulators, BACH2 (BTB and CNC homology 1, basic leucine zipper transcription factor 2) and BCL6 (B‐cell CLL/lymphoma 6), in a cohort of 102 CLL patients and determined the protein interaction networks that they participate in using MEC‐1 CLL cells. We observed that CLL patients expressing low levels of BCL6 and BACH2 RNA had significantly shorter overall survival (OS) than high BCL6‐ and BACH2‐expressing cases. Notably, their low expression specifically decreased the OS of immunoglobulin heavy chain variable region‐mutated (IGHV‐M) CLL patients, as well as those with 11q and 13q deletions. Similar to the RNA data, a low BACH2 protein expression was associated with a significantly shorter OS than a high expression. There was no direct interaction observed between BACH2 and BCL6 in MEC‐1 CLL cells, but they shared protein networks that included fifty different proteins. Interestingly, a prognostic index (PI) model that we generated, using integrative risk score values of BACH2 RNA expression, age, and 17p deletion status, predicted patient outcomes in our cohort. Taken together, these data have shown for the first time a possible prognostic role for BACH2 in CLL and have revealed protein interaction networks shared by BCL6 and BACH2, indicating a significant role for BACH2 and BCL6 in key cellular processes, including ubiquitination mediated B‐cell receptor functions, nucleic acid metabolism, protein degradation, and homeostasis in CLL biology.

Publication metadata

Author(s): Ciardullo C, Szoltysek K, Zhou P, Pietrowska M, Marczak L, Willmore E, Enshaei A, Walaszczyk A, Ho JY, Rand V, Marshall S, Hall AG, Harrison CJ, Soundararajan M, Eswaran J

Publication type: Article

Publication status: Published

Journal: Cancers

Year: 2022

Volume: 14

Issue: 1

Online publication date: 21/12/2021

Acceptance date: 17/12/2021

Date deposited: 07/01/2022

ISSN (electronic): 2072-6694

Publisher: MDPI


DOI: 10.3390/cancers14010023


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Funder referenceFunder name
12005Bloodwise (Formerly Leukaemia and Lymphoma Research)
Blood Cancer UK
Bright Red
JGW Patterson Foundation
Marie Curie International Incoming Fellowship