胸腺细胞选择相关的高迁移率族盒蛋白（TOX）和核受体4A（NR4A）成员被认为是参与T细胞耗竭的转录因子。评估急性CD8 T细胞中TOX和NR4A1-3的mRNA表达血液样本取自 21 名 ALL 和 6 名 AML 患者以及 20 名对照受试者。使用 MACS 分离 CD8 T 细胞。然后使用qRT-PCR评估TOX和NR4A1-3的相对基因表达。CD8 T细胞中TOX mRNA表达的比较显示各研究组之间没有显着差异（p>0.05），而NR4A1的表达在研究组中显着较低。 AML患者高于对照组(p=0.0006)。此外，NR4A2 和 NR4A3 的表达在 ALL（分别为 p=0.0049 和 p=0.0005）和 AML（分别为 p=0.0019 和 p=0.0055）患者中显着较低。 NR4As 表达在 CD8 T 中较低与对照组相比，AML和ALL患者的细胞，而TOX的mRNA表达没有显着差异。尽管TOX和NR4As与实体瘤中CD8 T细胞耗竭有关，但它们在急性白血病中可能发挥不同的作用，这需要进一步研究。

Thymocyte selection-associated high mobility group box protein (TOX) and members of the nuclear receptor 4A (NR4A) are known as transcription factors involved in T cell exhaustion.To evaluate the mRNA expression of TOX and NR4A1-3 in CD8+ T cells in acute leukemia.Blood samples were obtained from 21 ALL and 6 AML patients as well as 20 control subjects. CD8+ T cells were isolated using MACS. Relative gene expression of TOX and NR4A1-3 was then evaluated using qRT-PCR.Comparison of mRNA expression of TOX in CD8+ T cells showed no significant difference among the study groups (p>0.05), while the expression of NR4A1 was significantly lower in AML patients than in the control group (p=0.0006). Also, the expression of NR4A2 and NR4A3 was significantly lower in both ALL (p=0.0049 and p=0.0005, respectively) and AML (p=0.0019 and p=0.0055, respectively) patients.NR4As expressions were found to be lower in CD8+ T cells from patients with AML and ALL compared to controls, whereas the mRNA expression of TOX showed no significant difference. Although TOX and NR4As are associated with CD8+ T cell exhaustion in solid tumors, they might play different roles in acute leukemia, which requires further investigation.