Background. Acute lymphoblastic leukemia (ALL) is a malignant disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoietic cells of the marrow. Philadelphia chromosome (Ph)-positive ALL, a high-risk cytogenetic subset, accounts for 25-30% of adult ALL cases but occurs in less than 5% of children. We aimed with this study to detect Ph chromosome in acute lymphoblastic leukemia patients, using (FISH), and to assess their relation with other standard prognostic factors and therapeutic response.
Patients and methods. This study was carried out on 39  newly diagnosed ALL patients. All patients were subjected to; History, clinical examination and Laboratory investigations, which included CBC (Complete Blood Count), P.BL.(Peripheral Blood) smear and BM(Bone Marrow) examination, immunophenotyping and Fluorescence in situ hybridization to detect Ph chromosome.
Results. This study was carried out on 39  newly diagnosed ALL patients show: Statistical analysis of patients' t(9;22) with other factors revealed significant association (p35 years, hepatosplenomegaly, absence of lymphadenopathy, TLC ≥50X10⁹/L,  absolute P.Bl blasts ≥4.4X10⁹/L and immunophenotyping.
Conclusion. Ph chromosome expression serve as a powerful prognostic marker in adulthood ALL, As ph +ve adult acute lymphoblastic leukemia has poor prognosis and can be used as prognostic indicators for therapeutic response