الفهرس 
CHRONIC MYELOID LEUKAEMIAOnly 14 pages are availabe for public view
 |  | from | 158 |  |  |
| | | from | 158 | | |
Abstract
Abstract
Background: Depending on breakpoints of rearrangements, different types of BCR–ABL fusion protein can be generated in patients of chronic myeloid leukemia (CML). The knowledge of differences in breakpoints might have some clinical importance, and disease phenotype of patients may vary.
Objectives: The aim of this study is to observe frequencies of major transcripts in elderly CML patients in different centers in Egypt by reverse transcriptase polymerase chain reaction (RT-PCR) and to assess the impact of ethnic and demographic variables on disease outcome, particularly according to gender and age and to study the relationships of different transcript types with the disease characteristics and response to treatment type.
Patients and Methods: This study was conducted on 100 patients with CML from databases of Ain Shams University CML clinic and Hematology and Bone Marrow units, databases of Laboratories testing BCR-ABL for diagnostic purposes & Other contributing medical centers. Consecutive peripheral blood samples of 100 newly diagnosed CML patients (47 males, 53 females) with age range (50 years to <70 years) in chronic phase were analyzed by RT-PCR to detect different BCR–ABL transcripts. Routine blood cell counts were assessed by an automated hematology analyzer.
Results: Patients were divided into 3 groups according to BCR-ABL transcript type. 41 patients had b2-a2, 44 patients had b3-a2 and 15 patients had both. (41%, 44% and 15% respectively).
All patients presented with splenomegaly, the mean size of spleen was 18 cm at diagnosis. All patients presented with leukocytosis, mean basophilic count was (4×103/µL), mean eosinophilic count was (5.35×103/µL), mean platelet count was (414.4×103/µL). Higher mean platelet count was noted in patients with b2-a2 transcript, but this difference was statistically insignificant (P = 0.1).Patients’ BCR-ABL levels were measured by PCR at 5 time points: Initially, at 3 months, at 6 months, at 9 months and at 12 months.
Risk stratification according to Sokal score was done. 30 patients were of low risk, 57 patients were of intermediate risk and 13 patients were of high risk (30%, 57% and 13% respectively).
Mean Sokal score in patients with b2-a2 was 0.79, in patients with b3-a2 was 0.88 and in patients with both transcript was 0.83.Risk stratification according to Hasford score was done, 55 patients were of low risk, 45 patients were of intermediate risk and there were no high risk patients (55%, 45% and 0% respectively).
Mean Hasford score in patients with b2-a2 was 652.9, in patients with b3-a2 was 831.9 and in patients with both transcript was 914.4.
All patients had low EUTOS risk score. Mean EUTOS score in patients with b2-a2 was 41.9, in patients with b3-a2 was 54.7 and in patients with both transcript was 53.5.
Patients with b2-a2 had higher PCR levels than the other 2 groups initially and at 3 months. The difference was statistically significant. Initially, PCR was higher in patients with b2-a2 compared to patients with b3-a2 and to patients with both (p=0.001 and p=0.011 respectively).At 3 months, PCR was higher in patients with b2-a2 compared to patients with b3-a2 (p=0.018).
All other differences were not statistically significant.