THE COMMON CYTOGENETIC ABNORMALITIES IN ACUTE MYELOID LEUKEMIA PATIENTS
Abstract
Background: Acute myeloid leukaemia (AML) is malignant neoplasms of myeloid cells categorized by clonal expansion of hematopoietic blasts of myeloid lineage in peripheral blood and bone marrow. The aim of current study is to identify the common cytogenetic abnormalities in AML patients presenting at a tertiary care hospital of Pakistan. Methods: It was a cross-sectional study conducted at the department of Medical oncology of the Jinnah Postgraduate Medical Center, Karachi from Jun 2017- Jan 2019. The non-probability consecutive sampling technique was used to select patients. Total 92 cases of AML of age 15-55 years of either gender were included in the study. The detection of cytogenetic abnormality was done on the bone marrow biopsy. The cytogenetic abnormalities were classified into the three cytogenetic risk groups as favourable, intermediate and unfavourable. For analysis of data SPSS 23 version was used. Results: The cytogenetic abnormalities were detected in 34(37%) of the AML patients while 58 (63%) patients had normal cytogenetic. Thirty-two females (34.8%) had a normal cytogenetic (46; XX), and 15 females (16.3%) had various cytogenetic abnormalities. Twenty-six males (28.3%) had normal cytogenetic (46; XY) and 19 males (20.7%) had various cytogenetic abnormalities. Most of the patients were in intermediate risk group (67.4%), followed by favourable (17.4%) and unfavourable risk group (15.2%). The most frequent chromosomal abnormalities observed were complex cytogenetic which was detected in 5 AML patients. Conclusion: In the present study cytogenetic abnormalities were found in 37% of AML patients. Sixty-seven of the AML patients were in intermediate risk group and five patients had complex cytogenetic. Hence the cytogenetic analysis provides significant information regarding prognosis of AML patients and the cytogenetic abnormalities are less than international literature.
Keywords: Cytogenetic abnormalities; Acute myeloid leukaemia; Normal cytogenetic; Complex cytogeneticReferences
Saultz JN, Garzon R. Acute Myeloid Leukemia: A Concise Review. J Clin Med 2016;5(3):E33.
ACS. Key Statistics for Acute Myeloid Leukemia (AML) 2019. [Internet]. [cited 2019 Sep]. Available from: https://www.cancer.org/cancer/acute-myeloid-leukemia/about/key-statistics.html
Yang XF, Sun AN, Yin J, Cai SC, Tian XP, Qian J, et al. Monosomal karyotypes among 1147 Chinese patients with acute myeloid leukemia: prevalence, features and prognostic impact. Asian Pac J Cancer Prev 2012;13(11):5421-6.
Chin YM, Noor PJ, Ismail A, Ahid MF, Zakaria Z, et al. Cytogenetic Profile of Monosomal Karyotype in Adult Acute Myeloid Leukemia. Int J Sci Res 2013;3(11):1-5.
Meng CY, Noor PJ, Ismail A, Ahid MF, Zakaria Z. Cytogenetic Profile of de novo Acute Myeloid Leukemia Patients in Malaysia. Int J Biomed Sci 2013;9(1):26-32.
Slovak ML, Kopecky KJ, Cassileth PA, Harrington DH, Theil KS, Mohamed A, et al. Karyotypic analysis predicts outcome of preremission and postremission therapy in adult acute myeloid leukemia: a Southwest Oncology Group/Eastern Cooperative Oncology Group Study. Blood 2000;96(13):4075-83.
O'Donnell MR, Abboud CN, Altman J, Appelbaum FR, Arber DA, Attar E, et al. NCCA Clinical practice guideline acute myeloid leukemia. J Natl Compr Canc Netw 2012;10(8):984-1021.
Ross JA, Spector LG, Robison LL, Olshan AF. Epidemiology of leukemia in children with Down syndrome. Pediatr Blood Cancer 2005;44(1):8-12.
Li X, Li X, Xie W, Hu Y, Li J, Du W, et al. Comprehensive profile of cytogenetics in 2308 Chinese children and adults with de novo acute myeloid leukemia. Blood Cells Mol Dis 2012;49(2):107-13.
Shaikh MS, Ahmed ZA, Shaikh MU, Adil SN, Khurshid M, Moatter T, et al. Distribution of Chromosomal Abnormalities Commonly Observed in Adult Acute Myeloid Leukemia in Pakistan as Predictors of Prognosis. Asian Pac J Cancer Prev 2018;19(7):1903-6.
Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood 2016;127(20):2391-405.
Schoch C, Haferlach T. Cytogenetics in acute myeloid leukemia. Curr Oncol Rep 2002;4(5):390-7.
Alrajeh AI, Abalkhail H, Khalil SH. Cytogenetics and molecular markers of acute myeloid leukemia from a tertiary care center in Saudi Arabia. J Appl Hematol 2017;8(2):68-74.
Juliusson G, Antunovic P, Derolf A, Lehmann S, Mollgard L, Stockelberg D, et al. Age and acute myeloid leukemia: real world data on decision to treat and outcomes from the Swedish Acute Leukemia Registry. Blood 2009;113(18):4179-87.
Sultan S, Zaheer HA, Irfan SM, Ashar S. Demographic and Clinical Characteristics of Adult Acute Myeloid Leukemia--Tertiary Care Experience. Asian Pac J Cancer Prev 2016;17(1):357-60.
Venkateswaran SP, Jojo A, Vidhyadharan G, Unni M. A clinicopathological correlation of acute leukaemias in relation to immunophenotyping and cytogenetics. Int J Collab Res Intern Med Public Health 2012;4(10):1713-37.
Chauhan PS, Ihsan R, Singh LC, Gupta DK, Mittal V, Kapur S. Mutation of NPM1 and FLT3 genes in acute myeloid leukemia and their association with clinical and immunophenotypic features. Dis Markers 2013;35(5):581-8.
Pastore F, Dufour A, Benthaus T, Metzeler KH, Maharry KS, Schneider S, et al. Combined molecular and clinical prognostic index for relapse and survival in cytogenetically normal acute myeloid leukemia. J Clin Oncol 2014;32(15):1586-94.
Lazarevic V, Hörstedt AS, Johansson B, Antunovic P, Billström R, Derolf A, et al. Incidence and prognostic significance of karyotypic subgroups in older patients with acute myeloid leukemia: the Swedish population-based experience. Blood Cancer J 2014;4(2):e188.
Weinberg OK, Sohani AR, Bhargava P, Nardi V. Diagnostic work-up of acute myeloid leukemia. Am J Hematol 2017;92(3):317-21.
Marchesi F, Annibali O, Cerchiara E, Tirindelli MC, Avvisati G. Cytogenetic abnormalities in adult non-promyelocytic acute myeloid leukemia: a concise review. Crit Rev Oncol Hematol 2011;80(3):331-46.
Kumar CC. Genetic abnormalities and challenges in the treatment of acute myeloid leukemia. Genes Cancer 2011;2(2):95-107.
Byrd JC, Mrozek K, Dodge RK, Carroll AJ, Edwards CG, Arthur DC, et al. Pretreatment cytogenetic abnormalities are predictive of induction success, cumulative incidence of relapse, and overall survival in adult patients with de novo acute myeloid leukemia: results from Cancer and Leukemia Group B (CALGB 8461). Blood 2002;100(13):4325-36.
Walter RB, Othus M, Burnett AK, Lowenberg B, Kantarjian HM, Ossenkoppele GJ, et al. Significance of FAB subclassification of "acute myeloid leukemia, NOS" in the 2008 WHO classification: analysis of 5848 newly diagnosed patients. Blood 2013;121(13):2424-31.
Sadiq MA, Shamshad GU, Ali N, Ghani E, Ahmed S, Arshad M. Haematological manifestations and frequency of fab subtypes in patients of acute myeloid leukaemia: a single center study. Pak Arm Forces Med J 2015;65(5):610-5.
Udupa MN, Babu KG, Babu MS, Lakshmaiah K, Lokanatha D, Jacob AL, et al. Clinical profile, cytogenetics and treatment outcomes of adult acute myeloid leukemia. J Cancer Res Ther 2018:243471.
Downloads
Published
How to Cite
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
