{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T10:38:06Z","timestamp":1777631886823,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T00:00:00Z","timestamp":1575936000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto Nacional de C\ufffdncer"},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\ufffdfico e Tecnol\ufffdgico","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Funda\ufffd\ufffdo de Amparo a Pesquisa do Estado do Rio de Janeiro"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2019,12,10]]},"abstract":"<jats:p>Pediatric myelodysplastic syndrome (MDS) is an uncommon disease and little is known about the molecular alterations of its development and evolution to acute myeloid leukemia (AML). The <jats:italic>Enhancer of Zeste Homolog 2<\/jats:italic> (<jats:italic>EZH2<\/jats:italic>) is the catalytic subunit of Polycomb repressive complex 2 (PCR2). It is a histone methyltransferase, that targets lysine 27 of histone 3. This methylated H3\u2013K27 is usually associated with the silencing of genes that are involved in fundamental cellular processes, such as cell proliferation and differentiation. There are only few studies showing the status of <jats:italic>EZH2<\/jats:italic> expression in patients with MDS and they were performed in adult MDS patients. The aim of this study was to analyze the <jats:italic>EZH2<\/jats:italic> expression in pediatric patients with MDS and its association with karyotypes and evolution to acute myeloid leukemia (AML). We conducted the first study of <jats:italic>EZH2<\/jats:italic> expression in pediatric patients with MDS. Considering the <jats:italic>EZH2 <\/jats:italic>expression levels in 42 patients and 17 healthy pediatric donors, it was possible to define three groups of expression in patients: low, intermediate, and high. The intermediate level encompassed patients with normal karyotypes, low level included patients with monosomy 7 and del(7q) and high level included patients with trisomy 8 and del(11q) (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.0001<\/mml:mn><\/mml:mrow><\/mml:math>). Comparing the leukemic evolution, the low expression group presented disease evolution in 100% (8\/8) of the cases, the intermediate expression group showed disease evolution in 4.34% (1\/23) and in the high expression group, 63.63% (7\/11) patients showed evolution from MDS to AML (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mrow><mml:mi>p<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.0001<\/mml:mn><\/mml:mrow><\/mml:math>). It is important to note that low and high <jats:italic>EZH2<\/jats:italic> expression are associated with leukemic evolution, however low expression showed a stronger association with evolution from MDS to AML than the high expression. Our results suggest a scale of measure for <jats:italic>EZH2 <\/jats:italic>expression in pediatric MDS, where aberrant <jats:italic>EZH2 <\/jats:italic>expression may be a potential biomarker of disease evolution.<\/jats:p>","DOI":"10.1155\/2019\/3176565","type":"journal-article","created":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T18:30:52Z","timestamp":1576002652000},"page":"1-9","source":"Crossref","is-referenced-by-count":4,"title":["Aberrant Expression of <i>EZH2 <\/i>in Pediatric Patients with Myelodysplastic Syndrome: A Potential Biomarker of Leukemic Evolution"],"prefix":"10.1155","volume":"2019","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1299-4666","authenticated-orcid":true,"given":"Teresa","family":"de Souza Fernandez","sequence":"first","affiliation":[{"name":"Bone Marrow Transplantation Center, National Cancer Institute (INCA), 20230-130 Rio de Janeiro, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5119-0129","authenticated-orcid":true,"given":"Tatiana","family":"Fonseca Alvarenga","sequence":"additional","affiliation":[{"name":"Pathological Anatomy Department (DIPAT), National Cancer Institute (INCA), 20230-130 Rio de Janeiro, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elaiza","family":"Almeida Ant\u00f4nio de K\u00f3s","sequence":"additional","affiliation":[{"name":"Bone Marrow Transplantation Center, National Cancer Institute (INCA), 20230-130 Rio de Janeiro, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8493-5855","authenticated-orcid":true,"given":"Viviane","family":"Lamim Lovatel","sequence":"additional","affiliation":[{"name":"Bone Marrow Transplantation Center, National Cancer Institute (INCA), 20230-130 Rio de Janeiro, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita de C\u00e1ssia","family":"Tavares","sequence":"additional","affiliation":[{"name":"Bone Marrow Transplantation Center, National Cancer Institute (INCA), 20230-130 Rio de Janeiro, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5340-5816","authenticated-orcid":true,"given":"Elaine Sobral","family":"da Costa","sequence":"additional","affiliation":[{"name":"Pediatrics Department, Faculty of Medicine, Federal University of Rio de Janeiro, 21941-590 RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cec\u00edlia","family":"de Souza Fernandez","sequence":"additional","affiliation":[{"name":"Mathematical and Statistical Institute of Federal Fluminense University (UFF), 24020-140 Niter\u00f3i, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5166-0832","authenticated-orcid":true,"given":"Eliana","family":"Abdelhay","sequence":"additional","affiliation":[{"name":"Bone Marrow Transplantation Center, National Cancer Institute (INCA), 20230-130 Rio de Janeiro, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbior.2014.11.002"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2010.505820"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2018.04.007"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-09-765214"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/542395"},{"issue":"7","key":"6","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1016\/j.leukres.2012.04.003","volume":"36","year":"2012","journal-title":"Leukemia 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