Philadelphia Chromosome In Acute Lymphoblastic Leukemia

Authors

1 Department of Clinical Pathology, Faculty of Medicine, Ain Shams University

2 Department of Clinical Pathology,Faculty of Medicine, Sohag University.

3 Department of clinical and chemical pathology, Sohag Faculty of Medicine, Sohag University.

4 Department of Clinical and Pathology,sohag faculty of medicine,sohag university

Abstract

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

Jiang H (2010): The different signal patterns of two FISH probes in the FISH detection of Ph-positive leukemia and their clinical significance 2010 Apr;27(2):166-70. doi: 10.3760/cma.j.issn.1003-9406.2010.02.011.
2- Ghazavi F, Tim L, Nadine VR, Bruce P, Frank S, Yves B, Pieter VV and Barbara DM. (2015):   “Molecular basis and clinical significance of genetic aberrations in B-Cell precursor acute lymphoblastic leukemia.” Experimental Hematology, vol. 43, no. 8, pp.640–653., doi:10.1016/j.exphem.
3-Bachanova, Veronika (2017): "Philadelphia-positive Acute Lymphoblastic Leukemia: Do We Still Need Allogeneic Transplantation? Argument “Pro”." Clinical Lymphoma Myeloma and Leukemia 17 (2017): S10-15. Copyright © 2017 Elsevier Inc.
4- Gersen S, and Keagle M. (2013): The Principles of Clinical Cytogenetics (Third Edition ed., p. 561). New York: Springer Science Business Media New York.
5-Pita M, Orellana J, Martinez-Rodriguez P, Martinez-Ramirez A, Fernandez-Calvin B and Bella J (2014): In FISH methods in cytogenetic studies. In Functional Analysis of DNA and Chromatin (Methods in Molecular Biology); (first edition), Chapter (10); 1094:109-35, Springer Sceince+ Business Media, New York, USA.
6- Noreen S, Zafar I, Aamer A, Tashfeen A, Tahir N and Sultan A.(2012): Prognostically significant fusion oncogenes in Pakistani patients with adult acute lymphoblastic leukaemia and their association with disease
 
biology and outcome. Asian Pacific J Cancer Prev 2012;13.7:3349-55.
7- Schafer Eric S.; Margolin, Judith; Poplack, David G. and Rabin, Karen R. (2015): . Molecular Genetics of Acute Lymphoblastic Leukemia, Molecular Basis of Cancer, 4th ed, vol. 26, 395-406.
8- Al Ustwania Omar, Neha Guptab, Hatoon Bakhribaha, Elizabeth Griffithsa, Eunice Wanga and Meir Wetzler (2016): Clinical updates in adult acute lymphoblastic leukemia, Critical Reviews in Oncology/Hematology 99; 189–199.
9- Ilana de France, Rui Milton P, Audrey Violeta M, Washington B, Fárida C and Raul A.,(2014) : “Frequency of p190 and p210 BCR-ABL rearrangements and survival in Brazilian adult patients with acute lymphoblastic leukemia.” Fundac¸ão de Hematologia e Hemoterapia de Pernambuco (HEMOPE), vol. 36, no. 5, 18 July 2014, pp. 351–355., doi:org/10.1016/j.bjhh.2014.07.016.
10- Cetin Z, Sezin Y,  Ihsan K, Alphan K,  Aysen T, Ozan S, Gulsun T, -Guchan A,  Demircan O, Volkan H, Mehmet AY, Levent U, Guven L, and Sibel B.(2012):  “Aberrations of Chromosomes 9 and 22 in Acute Lymphoblastic Leukemia Cases Detected by ES-FluorescenceIn SituHybridization.” Genetic Testing and Molecular Biomarkers, vol. 16, no. 5, pp. 318–323., doi:10.1089/gtmb.2011.0186.
11- Sanam Loghavi, Jeffery L. Kutok and Jeffrey L. Jorgensen. (2015):  “B-Acute Lymphoblastic Leukemia/Lymphoblastic Lymphoma .” American Journal of Clinical Pathology, vol. 144, no. 3, pp. 393–410., doi:org/10.1309/AJCPAN7BH5DNYWZB.
12- Aldoss I, Tracey S, Vinod P, Joycelynne P and Stephen F (2015): “The prognostic significance of additional cytogenetic abnormalities in adults with Philadelphia chromosome positive acute lymphoblastic leukemia undergoing allogeneic stem cell transplant.” Clinical Lymphoma Myeloma and Leukemia, vol. 15, doi:10.1016/j.clml.2015.04.012