Prognostic significance of MSI 2 predicts unfavorable outcome in adult B‐acute lymphoblastic leukemia

Summary Introduction The Musashi‐2 gene ( MSI 2 ) is implicated in leukemogenesis, and high MSI 2 expression has been associated with decreased survival in acute myeloid leukemia ( AML ) and acute lymphoid leukemia ( ALL ), suggesting its use as a new prognostic marker. We aimed to validate the prognostic significance of MSI 2 in ALL . Methods MSI 2 expression was measured by real‐time polymerase chain reaction in 140 adult B‐ ALL patients and compared to controls. Results MSI 2 expression level in patients was significantly higher when compared to the control group ( P  = 0.001). High MSI 2 expression did not correlate with the clinical characteristics of patients. However, patients with high MSI 2 expression had significantly lower incidence of complete remission ( CR ) ( P  = 0.03), inferior overall survival ( P  = 0.018), and shorter disease‐free survival ( P  = 0.001). Multivariate analysis revealed that high MSI 2 expression was an independent prognostic factor for adult BCR ‐ ABL 1 ‐negative B‐ ALL patients. Conclusion These results confirm the association of MSI 2 expression with outcome in adult B‐ ALL and demonstrate the utility of MSI 2 as a clinical prognostic biomarker.