CRLF2 expression in DS-ALL. (A) CRLF2 expression in the AIEOP (i), BFM (ii), and ICH (iii) datasets. The y-axis represents CRLF2 log basis 2 expression. The x-axis represents the different ALL subtypes. Each point corresponds to a sample. The black line in each ALL subtype is the CRLF2 mean (log basis 2) expression in this subtype. The height of the blue rectangle in each ALL subtype is the measured standard deviation of CRLF2 (log basis 2) expression. DS-ALL versus all other ALL yielded t test P values of less than .001 for AIEOP (i), BFM (ii), and ICH (iii). DS indicates Down syndrome ALL; HD, high hyperdiploid; TEL, TEL-AML1; BCR, BCR-ABL; E2A, E2A-PBX1; and MLL, MLL-AF4. (B) IL7RA expression in the AIEOP (i), BFM (ii), and ICH (iii) datasets. There are no statistically significant differences between DS-ALLs and non–DS-ALLs. (C) Verification of CRLF2 expression levels by qRT-PCR. Bars represent qRT-PCR CRLF2 expression levels (left, y-axis: fold change relative to patient DS-12, the lowest CRLF2 expressor). Rhombuses represent gene expression array CRLF2 expression levels (right, y-axis: log basis 2). Red bars represent patients with JAK2 R683 mutation; blue bars, patients with CRLF2 F232C mutation (Figure 6). Rem indicates CRLF2 levels of available remission samples (patients DS-19 and DS-20); CONT, control CRLF2 expression levels in peripheral white blood cells of healthy donors. (D) CRLF2 and IL7RA protein expression on the surface of DS-ALL leukemic blasts. (Left panel) Delta mean fluorescence intensity of the signal detected by flow cytometry using specific anti-CRLF2 antibodies compared with background unspecific staining (“Flow cytometric analysis”), indicating an apparent association between the JAK2 mutational status and the level of expression of CRLF2 on DS-ALL blasts. (Right panel) Dot plot of 2 representative CRLF2 and IL7RA costainings. IL7RA is highly expressed on leukemic blasts independent of JAK2 mutational status and level of CRLF2 expression in all cases examined. wt indicates wild-type; mut, mutant; het, heterozygous; and hom, homozygous.