BAALC, also known as Brain and Acute Leukemia, Cytoplasmic, is a gene highly expressed in CD34-positive hematopoietic stem cells and is considered a marker of the mesodermal lineage, especially muscle [1,4]. It has been associated with multiple biological processes and diseases, especially leukemia. In leukemia, it may be involved in pathways related to cell adhesion, cell-cycle progression, and chemoresistance [1,3].

In leukemia research, high BAALC expression is associated with poor prognosis in several types of acute myeloid leukemia (AML). For example, in NPM1-wild type/FLT3-ITD negative cytogenetically normal-AML patients, BAALC overexpression is related to CD34 positivity on leukemic blasts, absence of NPM1 gene mutation, presence of RUNX1 gene mutation, and poor patient outcomes [2]. BAALC physically interacts with DBN1, an actin-binding protein, which contributes to the anchoring of BAALC-expressing cells in the bone marrow and leads to resistance to cytotoxic drugs [1]. BAALC also potentiates the oncogenic ERK pathway through interactions with MEKK1 and KLF4, inducing cell-cycle progression of leukemia cells, conferring chemoresistance, and blocking monocytic differentiation [3].

In conclusion, BAALC is a crucial gene mainly implicated in leukemia. Its high expression is often linked to poor prognosis and drug resistance in leukemia patients. Understanding the functions of BAALC through research can potentially provide new therapeutic targets and strategies for treating leukemia.