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Background    ETS2  is a downstream effector of the RAS/RAF/ERK pathway, which plays a critical role in the development of malignant tumor. However, the clinical impact of  ETS2  expression in AML remains unknown.Methods  In this study, we evaluated the prognostic significance of  ETS2  expression using two relatively large cohorts of AML patients.    Results  In the first cohort, compared to low expression of  ETS2  ( ETS2   low ), high expression of  ETS2  ( ETS2   high ) showed significant shorter OS, EFS and RFS in the current treatments including the allogeneic HCT group (n = 72) and the chemotherapy group (n = 100). Notably, among  ETS2   high  patients, those received allogeneic HCT had longer OS, EFS and RFS than those with chemotherapy alone (allogeneic HCT, n = 39 vs. chemotherapy, n = 47), but treatment modules play insignificant role in the survival of  ETS2   low  patients (allogeneic HCT, n = 33 vs. chemotherapy, n = 53). Moreover, gene/microRNA expression data provides insights into the biological changes associated with varying  ETS2  expression levels in AML. The prognostic value of  ETS2  was further validated in the second AML cohort (n = 329).    Conclusions  Our results indicate that  ETS2   high  is a poor prognostic factor in AML and may guide treatment decisions towards allogeneic HCT.    Electronic supplementary material  The online version of this article (doi:10.1186/s12967-017-1260-2) contains supplementary material, which is available to authorized users.

High expression of ETS2 predicts poor prognosis in acute myeloid leukemia and may guide treatment decisions