Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACK GROUND:
Chronic myeloid leukemia (CML) is a stem cell disorder associated with an acquired chromosomal abnormality, Philadelphia chromosome (Ph), which arises from the reciprocal translocation of part of long arm of chromosome 9, in which proto-oncogene ABL gene (ablson) is located, to long arm of chromosome 22, in which BCR gene (break point cluster region) is located forming BCR-ABL fusion gene. The suppression of BCR-ABL is likely to be crucial for therapeutic success. The development of the BCR-ABL-targeted Imatinib mesylate represents a paradigm shift in the treatment of CML.
OBJECTIVE:
This is a prospective study designed as a try to apply cytogenetic technique as a conformational diagnosis of Philadelphia chromosome (Ph) in CML patients and also, to follow up CML patients treated with imatinib mesylate (IM) for assessment of cytogenetic response of peripheral blood at different IM treatment duration.
METHODS:
Prephral blood samples were collected from CML patients every 3-6ms. At first, (310) prephral blood(PB) samples related to 135 CML patients were cultured but only 181(58 %) cultures related to (42) patients were successful (gave obvious metaphases). The degree of cytogenetic response of peripheral blood was quantified according to the proportion of Philadelphia chromosome positive metaphases.
RESULTS:
The results showed that (64.28%) of CML achieved major peripheral blood cytogenetic response while (35.71%) achieved partial cytogenetic response.
CONCLUSION:
Conventional cytogenetic karyotyping is necessary for Ph–chromosome detection and also, as an assay for periodical assessment of cytogenetic response in CML patients treated with imatinib. Imatinib has resulted in cytogenetic responses in first line IM treated patients and in those who have failed previous IFN-α therapy and in CML patients at early and late chronic phase.