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18.06.2021 | original report

Value of autophagy-related gene 5 (ATG5) expression as a prognostic marker in adults with newly diagnosed acute lymphoblastic leukaemia (ALL)

memo - Magazine of European Medical Oncology
Rasha I. Ibrahim, Haydi S. Mohamed, Mary G. Nagib, Hebatullah M. Fares, Alia M. Saeed
Wichtige Hinweise

Supplementary Information

The online version of this article (https://​doi.​org/​10.​1007/​s12254-021-00715-3) contains supplementary material, which is available to authorized users.

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Autophagy is considered a pivotal cellular mechanism to cope with stress and maintain homeostasis. It is frequently dysregulated in various types of cancers with some exhibiting excessive and others having reduced autophagy levels.


The goal was to determine autophagy status in newly diagnosed adult acute lymphoblastic leukaemia (ALL) patients compared to age- and sex-matched controls. Moreover, its prognostic impact on disease characteristics and response to treatment were evaluated.

Patients and methods

Thirty-five newly diagnosed adult ALL patients were recruited and age and sex matched to 15 healthy control subjects. ATG5 expression was measured on diagnosis using real-time quantitative polymerase chain reaction (qPCR). Cases have been followed up for one year after enrolment into the study.


Mean ATG5 expression in ALL was twice that of controls, which is a high statistically significant difference (2.15 ± 2.2 vs 1.09 ± 0.47, P value = 0.01). High ATG5 expression has been significantly associated with B‑ALL phenotype, lower haemoglobin and lower platelet counts. Of note, the higher expressor group had higher bone marrow and peripheral blood blast percentages and greater likelihood to develop chemoresistance to frontline agents, but this was not statistically significant. Further studies with larger numbers of patients are needed to examine the relationship between autophagy activation and therapeutic outcome in ALL.

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