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Study and Survey of BCR-ABL Transcript Types in Chronic Myeloid Leukemia (CML) Young Egyptian Patients

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Last updated: 22 Jan 2023

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Abstract

Background: Geographic and ethnic variations contribute to the variability of incidences among CML registries.  Reliable data concerning response rates to therapy in Arab nations is lacking. CML management areas are not in line with the current recommendations, due to sub-optimal timing of treatment decisions, under monitoring, and lack of molecular techniques or TKIs. Median age differs between cancer registries and clinical trials by 10-20 years. Objectives: Assessing the incidence of different BCR-ABL transcript types, among young Egyptian CML patients in different centers in Egypt to assess the impact of ethnic and demographic variables on disease outcome, particularly according to gender and age.  And, the relationships of different transcript types with the disease characteristics and response to treatment type. Patients and Methods: This study was conducted on 93 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, (51 males, 42 females) with age range (18 years to < 50 years) after obtaining a written informed consent. Results: Patients were divided into 3 groups according to BCR-ABL transcript type. 36 patients had b2-a2, 45 patients had b3-a2 and 12 patients had both. (38.7%, 48.4% and 12.9% respectively). Risk stratification according to Sokal score was done. 30 patients were of low risk, 60 patients were of intermediate risk and 3 patients were of high risk (32%, 65% and 3% 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 was 0.83.Risk stratification according to Hasford score was done. 48 patients were of low risk, 45 patients were of intermediate risk and there were no high risk patients (52%, 48% 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 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 was 53.5. All patients presented with splenomegaly, the mean size of spleen was 18 cm at diagnosis. All patients presented with leukocytosis, mean basophilic count was (3×103/µL), mean eosinophilic count was (6.35×103/µL), mean platelet count was (364.4×103/µL).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. 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. Conclusion: Patients with b2-a2 had higher PCR levels than the other 2 groups initially and at 3 months. There was no difference at 6 monthes & later.  

DOI

10.21608/ejhbmt.2021.169816

Keywords

Keywords: Chronic Myeloid Leukemia, BCR-ABL

Authors

First Name

Mohamed Osman

Last Name

Azzazi

MiddleName

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Affiliation

Department of Internal Medicine-Clinical Hematology and BMT, Faculty of Medicine, Ain Shams University.

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Orcid

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First Name

Mai

Last Name

Abd El-Mawgoud

MiddleName

Samir

Affiliation

Department of Internal Medicine-Clinical Hematology and BMT, Faculty of Medicine, Cairo University.

Email

dr.mai-samir@hotmail.com

City

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Orcid

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First Name

Omar

Last Name

Fahmy

MiddleName

Abd El-Rahman

Affiliation

Department of Internal Medicine-Clinical Hematology and BMT, Faculty of Medicine, Cairo University.

Email

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City

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Orcid

-

First Name

Mohamed

Last Name

Mousa

MiddleName

Mahmoud

Affiliation

Department of Internal Medicine-Clinical Hematology and BMT, Faculty of Medicine, Ain Shams University.

Email

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City

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Orcid

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First Name

Yasser Ibrahim

Last Name

Al-Nahas

MiddleName

-

Affiliation

Department of Internal Medicine-Clinical Hematology and BMT, Faculty of Medicine, Cairo University.

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City

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Orcid

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First Name

Hany

Last Name

Hegab

MiddleName

Abdullah

Affiliation

Department of Internal Medicine-Clinical Hematology and BMT, Faculty of Medicine, Ain Shams University

Email

hmhegab@gmail.com

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Orcid

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Volume

8

Article Issue

8

Related Issue

24791

Issue Date

2021-05-01

Receive Date

2021-05-01

Publish Date

2021-05-10

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1

Page End

8

Print ISSN

2356-9735

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https://ejhbmt.journals.ekb.eg/article_169816.html

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https://ejhbmt.journals.ekb.eg/service?article_code=169816

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Original Article

Type Code

726

Publication Type

Journal

Publication Title

Egyptian Journal of Hematology and Bone Marrow Transplantation

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https://ejhbmt.journals.ekb.eg/

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Article

Created At

22 Jan 2023