Prognostic Biomarker Replication Factor C Subunit 5 and Its Correlation with Immune Infiltrates in Acute Myeloid Leukemia

Objective: To determine the role of replication factor C subunit 5 (RFC5) in acute myeloid leukemia (AML) from four aspects: expression, prognosis, biological functions, and its effects on the immune system.

Methods: The RFC5 gene expression and survival analyses, biological function analyses including functional enrichment analysis of genes co-expressed with RFC5, RFC5-interacted gene network construction, gene set enrichment analysis (GSEA), and immune infiltration analysis were performed using data based on GDC TCGA and GEO. The CIBERSORT algorithm was employed to quantify immune cell fractions. All the statistical analyses were performed in SPSS software, GraphPad Prism, and R software.

Results: RFC5 expression was abnormally expressed in AML ( <0.05). Notably, differential RFC5 expression was observed among different FAB AML subtypes and hematopoietic lineages (all <0.05). More importantly, high RFC5 expression served as an independent prognostic factor for the poor overall survival of AML patients ( <0.001). Enrichment analyses revealed that RFC5 was involved in cell cycle-related pathways in AML. CIBERSORT analysis showed high proportions of M2 macrophages in the high RFC5 expression group.

Conclusions: RFC5 might serve as an effective and robust biomarker for the diagnosis and prognosis of AML. RFC5 might be involved in the AML progression via cell cycle regulation. Moreover, the correlation between RFC5 and immune cells might provide potential assistance for AML treatment.