The clinical significance of CDX2 in leukemia: A new perspective for leukemia research

•CDX2 could be used as a specific diagnostic marker in acute leukemias, such as ALL and AML.•The prognosis role of CDX2 has been indicated in some studies, but the findings are controversial.•It seems to be of great clinical interest for assessment of minimal residual diseases.•We have comprehensively evaluated the clinical significance of CDX2 in leukemia. CDX2 gene encodes a transcription factor involved in primary embryogenesis and hematopoietic development; however, the expression of CDX2 in adults is restricted to intestine and is not observed in blood tissues. The ectopic expression of CDX2 has been frequently observed in acute myeloid and lymphoid leukemia which in most cases is concomitant with poor prognosis. Induction of CDX2 in mice leads to hematologic complications, showing the leukemogenic origin of this gene. CDX2 plays significant role in the most critical pathways as the regulator of important transcription factors targeting cell proliferation, multi-drug resistance and survival. On the whole, the results indicate that CDX2 has the potential to be suggested as the diagnostic marker in hematologic malignancies. This review discusses the role of aberrant expression of CDX2 in the prognosis and the response to treatment in patients with different leukemia in clinical reports in the recent decades. The improvement in this regard could be of high importance in diagnosis and treatment methods.