CYTOGENETIC PROFILE OF ACUTE LYMPHOBLASTIC LEUKAEMIA PATIENTS AND ITS ASSOCIATION WITH INDUCTION REMISSION STATUS
Keywords:Keywords: Cytogenetics, Leukemia, Remission
AbstractBackground: To determine the cytogenetic abnormalities in patients of Acute Lymphoblastic Leukaemia as a predictor of response to induction chemotherapy.It was a descriptive cross sectional study. Methods: This study was conducted at the Armed Forces Institute of Pathology, Rawalpindi over a period of six months from June to November 2019. Bone marrow and peripheral blood samples of newly diagnosed 80 patients of all the age groups and either gender, who received one month treatment for ALL,were analyzed for cytogenetic study. Patients who were previously diagnosed with ALL, who presented with relapse and those who required induction treatment outside the trial hospital were excluded. UK ALL 2011 treatment protocol was adopted for patients up to 25years old and for patients above 25years old UK ALL 2014 treatment protocol as induction chemotherapy was adopted. Evaluation for remission was carried out at the termination of initial induction chemotherapy on day 29 of treatment. Results: A total of 80 patients were enrolled in the study, comprising 36(45%) females & 44(55%) males. The median age of paediatric patients was 5years (<19 years) who were 56/80(70%) in number whereas the median age of adults was 27 years (>19 years) who constituted 24/80 (30%) of the participants. Cytogenetic of 51(63.75%) patients revealed hyperdiploidy (chromosome number 51–66) whereas 29(36.25%) of the participants had miscellaneous mutations [(Hypodiploidy, t (9; 22), t (1; 19) and t (12; 21)]. On immunophenotyping 51/80 (63.7%) of the leukemias were of B cell origin and 29(36.25%) of T-cell origin.Conclusion: Patients with hyperdiploidy, t(12;21)ETV6/RUNX1 and t(1;19)TCF3/PBX1 had better prognosis and higher remission rate compared to those with the other mutations like t(9;22)Ph+ and hypodiploid which were associated with poor prognosis. Association of gender with remission was not statistically significant.
Wolfson JA, Richman JS, Sun CL, Landier W, Leung K, Smith EP, et al. Causes of inferior outcome in adolescents and young adults with acute lymphoblastic leukemia: across oncology services and regardless of clinical trial enrollment. Cancer Epidemiol Biomarkers Prev 2018;27(10):1133–41.
Thakral D, Kaur G, Gupta R, Benard-Slagter A, Savola S, Kumar I, et al. Rapid identification of key copy number alterations in B-and T-cell acute lymphoblastic leukemia by digital multiplex ligation-dependent probe amplification. Front Oncol 2019;9(2):871.
Alkhayat N, Elborai Y, Al-Sharif O, Al Shahrani M, Alsuhaibani O, Awad M, et al. Cytogenetic Profile and FLT3 Gene Mutations of Childhood Acute Lymphoblastic Leukemia. Clin Med Insights Oncol 2017;11(1):1179554917721710.
Gupta SK, Bakhshi S, Kumar L, Kamal VK, Kumar R. Gene copy number alteration profile and its clinical correlation in B-cell acute lymphoblastic leukemia. Leuk Lymphoma 2017;58(2):333–42.
Terwilliger T, Abdul-Hay MJ. Acute lymphoblastic leukemia: a comprehensive review and 2017 update. Blood Cancer J 2017;7(6):e577.
Von SA, Locatelli F, Zugmaier G, Handgretinger R, Trippett TM, Rizzari C, et al. Phase I/phase II study of blinatumomab in pediatric patients with relapsed/refractory acute lymphoblastic leukemia. J Clin Oncol 2016;34(36):4381–9.
Shwetha S, Lokanatha D, Sureshbabu M, Lokesh K. Expression of Aberrant Markers and its Association with Remission Post Induction Therapy in Acute Lymphoblastic Leukemia and Acute Myeloid Leukemia. J Clin Diagn Res 2021;15(7):88.
Xing C, Liang B, Wu J, Yang Q, Hu G, Yan Y, et al. Prognostic significance of leukopenia during the induction phase in adult B cell acute lymphoblastic leukemia. Cancer Manag Res 2018;10(1):625.
O’Connor D, Enshaei A, Bartram J, Hancock J, Harrison CJ, Hough R, et al. Genotype-specific minimal residual disease interpretation improves stratification in pediatric acute lymphoblastic leukemia. J Clin Oncol 2018;36(1):34–43.
Paul S, Kantarjian H, Jabbour EJ. Adult acute lymphoblastic leukemia. Mayo Clin Proc 2016;91(11):1645–66.
Khazaei Z, Goodarzi E, Adineh HA, Moradi Y, Sohrabivafa M, Darvishi I, et al. Epidemiology, Incidence, and Mortality of Leukemia in Children Early Infancy to 14 Years Old of Age in South-Central Asia: A Global Ecological Study. J Compr Pediatr 2019;10(1):e82258.
Gholamreza B, Marzeih N. Frequency of cytogenetic findings and its effect on the outcome of paediatric acute lymphoblastic leukemia. Med Arch 2019;73(5):311.
Agarwal M, Seth R, Lall M. Study of Cytogenetic Alterations and Association with Prognostic Factors in Indian Children With B-Lineage Acute Lymphoblastic Leukemia. Clin Lymphoma Myeloma Leuk 2020;20(7):e346–51.
Reddy P, Shankar R, Koshy T, Radhakrishnan V, Ganesan P, Jayachandran PK, et al. Evaluation of cytogenetic abnormalities in patients with acute lymphoblastic leukemia. Indian J Hematol Blood Transfus 2019;35(4):640–8.
Saima N. Immunophenotyping in acute lymphoblastic leukemia; association with demographic profile and clinical presentation. Int J Pathol 2018;17:20–30.
Schwab C, Harrison CJ. Advances in B-cell Precursor Acute Lymphoblastic Leukemia Genomics. HemaSphere 2018;2(4):e53.
Wang Y, Zeng HM, Zhang LP. ETV6/RUNX1 positive childhood acute lymphoblastic leukemia in China: excellent prognosis with improved BFM protocol. Ital J Pediatr 2018;44(1):1–6.
Musa Y, Hagop K, Farhad R, Nicholas J, Elias J. Philadelphia Chromosome-positive acute lymphoblastic leukemia in adults: current treatments and future perspectives. Clin Adv Hematol Oncol 2018;16(3):216–23.
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