Expression patterns of GPX4 and LINC00618 across disease phases in pediatric B-cell precursor acute lymphoblastic leukemia (BCP-ALL): an exploratory study

Acute lymphoblastic leukemia (ALL) remains a significant challenge in pediatric malignancies, particularly in cases of relapse and treatment resistance. This study aimed to investigate the expression patterns of ferroptosis-related genes, GPX4 and LINC00618, across different disease phases in pediatric B-cell precursor acute lymphoblastic leukemia (BCP-ALL). This case-control study analyzed 82 samples from pediatric BCP-ALL patients comprising 14 new cases, 29 in remission, and 17 relapsed cases alongside 22 healthy controls. Expression levels of GPX4 and LINC00618 were evaluated using quantitative real-time PCR. The relationship between gene expression and clinical parameters was assessed. Statistical analyses were performed employing parametric or nonparametric tests. GPX4 expression was significantly elevated in ALL patients compared to controls ( p < 0.01), with notably higher levels in new cases ( p < 0.01) and relapsed patients ( p < 0.05). Similarly, LINC00618 exhibited significant upregulation in ALL patients ( p < 0.05), particularly in new cases ( p < 0.01) and relapsed patients ( p < 0.05). Both genes demonstrated reduced expression during the remission. External validation using the GSE13159 dataset demonstrated a consistent direction of increased GPX4 expression in ALL samples compared to controls. Our findings suggest phase-associated expression patterns of GPX4 and LINC00618 in pediatric BCP-ALL. The consistent direction of GPX4 expression observed in external validation supports its potential relevance in leukemic biology. These results provide a basis for further studies to clarify the role of ferroptosis-related pathways in disease progression and therapeutic response.