Al-Anbar Medical Journal (Dec 2024)
Molecular, Cytogenetic, and Hematological Monitoring and Response to Treatment for Chronic Myeloid Leukemia Patients
Abstract
Background: A genetic abnormality in chronic myeloid leukemia (CML) involves a translocation between the long arms of chromosomes 9 and 22, known as t(9;22)(q34;q11.2), resulting in the Philadelphia chromosome (Ph). This translocation fuses the Abelson (ABL1) gene on chromosome 9 with the breakpoint cluster region (BCR) gene on chromosome 22, creating the BCR-ABL1 fusion gene, which is a key feature of CML.Objectives: To assess the prevalence and genetic anomalies of the Ph and BCR-ABL1 fusion gene in individuals diagnosed with CML. Besides, we aimed to investigate the relevance of CML corresponding with type of treatment, and the effectiveness of cytogenetics and molecular response with each other in addition to hematological response. Materials and methods: Quantitative real-time polymerase chain reaction (qRT-PCR) for specific fusion genes and cytogenetic analysis for Ph chromosome was done for 55 previously diagnosed CML patients, who were attended at Anbar Cancer Center in Anbar Governorate, Iraq, between March 2023 and February 2024.Results: In a study of 55 previously diagnosed CML patients, with a median age of 45. The commonest symptom was anemia (n = 50, 90.91%). The majority were male (61.82%). Hematological and molecular investigations revealed a significant improvement in the number of white blood cells (WBCs), the stability of red blood cells (RBCs), and hemoglobin (Hb) in the blood, accompanied by a reduction in the level of the BCR-ABL 1 gene according to the results of the qRT-PCR and a decline in the rate of abnormal cells shown by the karyotype.Conclusions: Monitoring CML effectively involves hematological, molecular, and cytogenetic evaluations. qRT-PCR offers a more rigid analysis than karyotype. Complete blood count (CBC) parameters are crucial along with qRT-PCR for follow-up disease stages and guiding treatment decisions.
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