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BACKGROUND:Acute lymphoblastic leukemia (ALL) occurs owing to the defective maturation,increased proliferation,and lack of differentiation of lymphoid cells.Evaluation of the expression levels of microRNAs (miRNAs) could help in the prognosis and improve the clinical outcome of ALL patients.Given the role of miR-21,miR-150,and miR-451 as oncogenes and tumor suppressors in lymphocytes,this study explored the relation between the expression levels of these miRNAs and the clinical outcomes of ALL patients.METHODS:cDNA synthesis and RT-PCR were performed for peripheral blood samples from 41 patients with ALL,as well as for U937 and Jurkat cell lines to examine the expression of miR-451,miR-150,and miR-21 after miRNA purification.We also performed an epidemiological analysis in which Mann-Whitney and Chi-square tests were used to investigate the relationship between the expression of miRNAs and other clinical and laboratory data.Binary logistic regression models were used to estimate the odds ratio in univariate and multivariate analyses for clinical outcomes.RESULTS:miR-21 and miR-150 expression was found to be decreased,while miR-451 expression showed no difference compared to the control group.There was a significant relationship between miR-451 expression and hemoglobin (Hb) levels,as well as between miR-150 expression and clinical outcomes of ALL patients.CONCLUSION:Increased expression of miR-451 decreased the Hb levels;reduced expression of miR-150 was associated with increased relapse rate in patients.Age,increased WBC,and decreased Hb levels were associated with increased relapse rates in ALL patients.Therefore,miR-150 could be used as a biomarker to determine the clinical outcome of ALL patients.