Abstract
The impact of BCR-ABL mRNA type (b3a2 vs. b2a2) on chronic myeloid leukemia (CML) phenotype is still a subject of controversies. We searched for a correlation between the BCR-ABL transcripts type and CML patients' characteristics, including MDR1 gene expression. Ninety-eight untreated chronic phase CML patients were studied. The type of BCR-ABL fusion transcripts and MDR1 gene expression were determined by reverse transcriptase polymerase chain reaction. B3a2 and b2a2 transcripts were found in 53 [54%] and 44 [45%] patients, respectively. One patient co-expressed b3a2/b2a2 and was excluded from analysis. The only difference in the clinical characteristics between the two groups was the platelets count, that was higher in b3a2(+) patients [791.3±441.3×109/L vs. 440.4±283.4×109/L in b2a2(+); P=0.007]. MDR1 over-expression [MDR1(+)] was observed in 48 patients (49.5%), more frequently in older patients >60 years [71% (24/34) vs. 38% (24/63) in younger; P=0.008], and was associated with a lower white blood cells (WBC) count [105.5±79.8× 109/L vs. 143.6±96.5×109/L in MDR1(−) cases; P=0.047]. On performing the analysis only within the MDR1(+) group, the b3a2(+) cases were characterized with a significantly higher platelets count [908.7±470.1×109/L vs. 472.9±356.1×109/L; P=0.006] and a lower WBC count [85.4±61.2×109/L vs. 130±93.9×109/L; P=0.004) compared to b2a2(+) patients. No similar differences were found between b3a2(+) and b2a2(+) groups with normal MDR1 levels. These results indicate that the type of BCR-ABL transcripts correlates with the hematological parameters of CML, however only in the subgroup of patients characterized by MDR1 over-expression.
Highlights
Gueorgui Balatzenko,[1] Babu Rao Vundinti,[2] Guenova Margarita[3 ] AbstractThe impact of BCR-ABL mRNA type (b3a2 vs. b2a2) on chronic myeloid leukemia (CML) phenotype is still a subject of controversies
The diagnosis of Chronic myeloid leukemia (CML) was established on the basis of the peripheral blood parameters and morphological analysis of peripheral blood and bone marrow aspirates and confirmed by the presence of Philadelphia chromosome and/or fusion BCR-ABL gene by conventional cytogenetics and reverse transcription polymerase chain reaction (RT-PCR) respectively
In this study we analyzed the type of BCRABL transcripts and Multidrug Resistance 1 (MDR1) gene expression in 98 untreated adult patients with chronic phase CML and correlated the findings with clinical, hematological and molecular data (Table 1)
Summary
Ninety-eight untreated consecutive chronic phase CML patients (59 males and 39 females) with a mean age 50.5±14.1 years were included in this study. All patients signed informed consent form before entry on study. The diagnosis of CML was established on the basis of the peripheral blood parameters and morphological analysis of peripheral blood and bone marrow aspirates and confirmed by the presence of Philadelphia chromosome and/or fusion BCR-ABL gene by conventional cytogenetics and reverse transcription polymerase chain reaction (RT-PCR) respectively
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