The influence of elevated body mass index on protein expression in pediatric b-cell acute lymphoblastic leukemia

This study explored protein expression in B-cell acute lymphoblastic leukemia (B-ALL) patients with and without elevated weight or obesity and controls to understand global proteomic differences between newly diagnosed B-ALL patients and controls as well as the influences of elevated body mass index (BMI) on pretreatment inflammatory and immune-related protein expression in B-ALL patients. Protein expression was measured in serum samples of pediatric patients (aged 1-21 years) with newly diagnosed B-ALL (n = 39), and age and sex-matched controls (n = 41) using OLink panels. We examined normalized protein expression data clustered by patient information in ­unsupervised hierarchical clustering and principal component analysis. Of 239 assays, 128 assays differed significantly based on B-ALL diagnosis and 4 assays (APLP1, CDHR5, GHRL, SEZ6L) varied significantly as a function of BMI. In healthy individuals, oncology marker furin (p.adjust = 0.016) was more highly expressed in the high-BMI category; this trend was reversed for B-ALL individuals. Furin expression is often upregulated in malignancies and obesity; however this suggests its expression may follow unique patterns in pediatric B- ALL patients with elevated BMI.