Evaluation of Expression Levels of Relapse-Associated Survivin, S100A8, GPM6B, NUDT15, AURKA and CASP1 Genes at Time of Diagnosis: A Case-Control Research Study in Childhood Pre-B- Acute Lymphoblastic Leukemia

Childhood pre-B acute lymphoblastic leukemia (pre-B-ALL) can be identified through routine genetic diagnostic methods in approximately 70-75% of cases. However, in 20-25% of cases, genetic abnormalities remain undetected at diagnosis, complicating the prediction of relapse risk, treatment response, and therapy-related cytotoxicity. Identifying reliable biomarkers is crucial for early diagnosis and optimized treatment strategies. Bone marrow samples were collected from 15 pediatric pre-B-ALL patients and 5 healthy child donors. Following cDNA synthesis, mRNA expression levels of AURKA, CASP1, GPM6B, NUDT15, S100A8, and Survivin genes were analyzed using qRT-PCR. AURKA, CASP1, and Survivin genes showed significantly increased expression in childhood pre-B-ALL cases (p< 0.05). However, no significant difference was observed for GPM6B, NUDT15, and S100A8. Kaplan-Meier analysis revealed no correlation between gene expression levels and relapse time. Spearman’s rho test showed a strong positive correlation between AURKA and Survivin expression (p< 0.0001). AURKA and Survivin overexpression are significantly correlated and may serve as potential biomarkers for predicting relapse in pediatric pre-B-ALL. CASP1 overexpression may indicate glucocorticoid resistance, potentially affecting treatment response; GPM6B, NUDT15, and S100A8 did not show significant relationships with relapse. Further validation in larger cohorts is required. Protein-level studies are needed to confirm the functional significance of these gene expression changes. Keywords: Pediatric B-ALL, qRT-PCR, Survivin, CASP1, AURKA