The SALL gene family is involved in normal development as well as tumor genesis. SALL4 is essential for the maintenance of the pluripotent and the self-renewal properties of embryonic stem cells.

Patients and methods It was conducted from the period of April 2008 to June 2012 on 40 patients with acute leukemia (group I), 20 patients who had nonmalignant hematologic disease (group II), and 20 healthy individuals (group III). They were subjected to laboratory investigations including a complete blood picture, RT-PCR for the detection of the SALL4 gene, for group I bone marrow aspiration biopsy, cytochemical studies, and immunophenotyping of either peripheral blood or bone marrow samples to diagnose and classify the hematologic malignancy.

Results SALL4 mRNA was expressed in 50% of the acute myeloid leukemia (AML) cases and was undetectable in 50% of the cases. Whereas it was expressed in only 20% of acute lymphoblastic leukemia (ALL), it was undetectable in 80% of ALL. SALL4 mRNA was undetectable in all cases of immune thrombocytopenic purpura (group II) (0%). SALL4 mRNA was undetectable in all samples of the control group (group III) (0%). There was no significant difference between the expression level of CD markers and SALL4 in AML cases, whereas there was a significant elevation of the CD10 expression level in SALL4-positive ALL cases (P < 0.05). There was a significant reduction in the RBC count and the hematocrite (Hct) and platelet level in SALL4-positive ALL cases (P < 0.05), and there was a statistically significant reduction in the platelet count in SALL4-positive AML cases.

Conclusion SALL4 mRNA expression was higher in cases of AML (50%), compared with ALL cases (20%). There was no SALL4 mRNA expression detected in all cases of immune thrombocytopenic purpura patients and in normal control individuals.