Prognostic value of the FUTfamily in acute myeloid leukemia

Genetic abnormalities are more frequently viewed as prognostic markers in acute myeloid leukemia (AML) in recent years. Fucosylation, catalyzed by fucosyltransferases (FUTs), is a post-translational modification that widely exists in cancer cells. However, the expression and clinical implication of the FUTfamily (FUT1-11) in AML has not been investigated. From the Cancer Genome Atlas database, a total of 155 AML patients with complete clinical characteristics and FUT1-11expression data were included in our study. In patients who received chemotherapy alone showed that high expression levels of FUT3, FUT6, and FUT7had adverse effects on event-free survival (EFS) and overall survival (OS) (all P< 0.05), whereas high FUT4expression had favorable effects on EFS and OS (all P< 0.01). However, in the allogeneic hematopoietic stem cell transplantation (allo-HSCT) group, we only found a significant difference in EFS between the high and low FUT3expression subgroups (P= 0.047), while other FUTmembers had no effect on survival. Multivariate analysis confirmed that high FUT4expression was an independent favorable prognostic factor for both EFS (HR = 0.423, P= 0.001) and OS (HR = 0.398, P< 0.001), whereas high FUT6expression was an independent risk factor for both EFS (HR = 1.871, P= 0.017) and OS (HR = 1.729, P= 0.028) in patients who received chemotherapy alone. Moreover, we found that patients with low FUT4and high FUT6expressions had the shortest EFS and OS (P< 0.05). Our study suggests that high expressions of FUT3/6/7predict poor prognosis, high FUT4expression indicates good prognosis in AML; FUT6and FUT4have the best prognosticating profile among them, but their effects could be neutralized by allo-HSCT.