{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T18:12:37Z","timestamp":1760465557450,"version":"build-2065373602"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82100170"],"award-info":[{"award-number":["82100170"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82202886"],"award-info":[{"award-number":["82202886"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82400275"],"award-info":[{"award-number":["82400275"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004608","name":"Natural Science Foundation of Jiangsu Province","doi-asserted-by":"publisher","award":["BK20210087"],"award-info":[{"award-number":["BK20210087"]}],"id":[{"id":"10.13039\/501100004608","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004608","name":"Natural Science Foundation of Jiangsu Province","doi-asserted-by":"publisher","award":["BK20230213"],"award-info":[{"award-number":["BK20230213"]}],"id":[{"id":"10.13039\/501100004608","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Gusu Talent Program","award":["GSWS2021001"],"award-info":[{"award-number":["GSWS2021001"]}]},{"name":"Gusu Talent Program","award":["GSWS2022019"],"award-info":[{"award-number":["GSWS2022019"]}]},{"name":"Gusu Talent Program","award":["GSWS202308"],"award-info":[{"award-number":["GSWS202308"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Acute myeloid leukemia (AML) patients with <jats:italic>FLT3<\/jats:italic>-ITD mutations were benefit from hematopoietic cell transplantation (HSCT) in the first complete remission. Previous research suggested that newly diagnosed AML patients with high allelic ratio (AR) of <jats:italic>FLT3<\/jats:italic>-ITD have unfavorable survivals, while newly diagnosed AML patients with lower <jats:italic>FLT3<\/jats:italic>-ITD AR and concomitant <jats:italic>NPM1<\/jats:italic> mutations have favorable outcomes. In AML patients with <jats:italic>FLT3<\/jats:italic>-ITD, co-occurrence with <jats:italic>DNMT3A<\/jats:italic>, and <jats:italic>NPM1<\/jats:italic> mutations (triple-mutated AML patients) have the worst prognoses, however, it is little known about how these mutations synergize in these triple-mutated AML patients. Here we showed that hepatic leukemia factor (<jats:italic>HLF<\/jats:italic>) gene was more highly expressed in triple-mutated AML patients than in those without the <jats:italic>DNMT3A<\/jats:italic> mutations. We found that <jats:italic>HLF<\/jats:italic> gene expressions had significant difference in triple-mutated and <jats:italic>FLT3-<\/jats:italic>ITD\/<jats:italic><jats:italic>NPM1<\/jats:italic><\/jats:italic> AML patients (double-mutated AML patients). Moreover, in <jats:italic>DNMT3A<\/jats:italic> mutated AML patients, correlated with high <jats:italic>HLF<\/jats:italic> gene expression, which may be itself associated with poor survival rate and drug resistance. Overall our data establish that <jats:italic>HLF<\/jats:italic> gene as a novel biomarker in this genetically defined the triple-mutated AML subgroup.<\/jats:p>","DOI":"10.1371\/journal.pone.0333690","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T17:28:46Z","timestamp":1760462926000},"page":"e0333690","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["HLF gene is a poor prognostic factor in acute myeloid leukemia patients with FLT3-ITD\/NPM1 mutations undergoing hematopoietic 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