Abstract
Chronic myeloid leukemia (CML) is one of leukemia types which account for 15 % to 20% of all leukemia cases. Patients are presented with splenomegaly, fever, anemia, fatigue, weight loss, and weakness. It is results from reciprocal translocation (9; 22).This abnormality is called Philadelphia (Ph) chromosome and it is detected in 95% of patients with CML, and in 20% of patients with Acute Lymphocytic Leukemia (ALL). "Imatinibmesylate” is the most widely used drug for CML treatment because it targets the abnormal fusion gene. Blood samples were collected from (39) CML patients (19 males and 20 females) from July - November 2009 in The NationalCenter of Hematology/Baghdad. The age range were(8 – 70) years. According to the real time PCR results; the patients were divided into four groups: 1) PCR negative group. 2) PCR positive group on Hydroxyurea treatment 3) PCR positive group on Gleevec® treatment 4) PCR positive group with no treatment (recently diagnosed).Patients were selected randomly. Their RNA was extracted from peripheral blood cells and reverse transcribed into cDNA which was amplified using real time PCR to measure the ratio of BCR-ABL fusion gene in their Philadelphia chromosome. This is to confirm the diagnosis and evaluate the response to the most widely used drugs for CML treatment (Gleevec® 400 mg/d and hydroxyurea 450 mg/d for two months at least). This study excluded CML diagnosis in 10 patients, so other myeloproliferative disorders need to be verified. The group treated with Gleevec® showed a better response than hydroxyurea at the molecular level.Key words: leukemia, chronic myeloid leukemia, polymerase chain reaction, real time PCR, BCR-ABL, quantitative PCR, hydroxyurea, imatinibmesylate, Philadelphia chromosome, tyrosine kinase.
Highlights
Provisional diagnosis was made by the consultant physician in the center and it was confirmed by a laboratory blood and bone marrow examination. Those patients were divided into two groups: * The first group included 10 patients who were suspected cases of Chronic myeloid leukemia (CML). They did not receive any medication till the date of this study and underwent RT-PCR to confirm the diagnosis. * The second group included 29 patients with a proved diagnosis of chronic myeloid leukemia (CML) and did the RT-PCR to measure the ratio of BCR/ABL fusion gene to ensure their diagnosis for first reading and to estimate the response to treatment by repeating the investigation every three months
That is why it is the first line of treatment in CML. This means that a low number of abnormal cells in the peripheral blood and better response. This conclusion is in agreement with [14] study about cytogenetic analysis and DNA estimation of blood cells from some patients with chronic myeloid leukemia in Baghdad and concluded that Gleevec® gave a better response than HU with the same duration of treatment
The result of log reading data in Table (4) is similar to the ratio result data since a better response to treatment was obtained in CML patients treated with Gleevec® which is less than the log reading for CML group treated with H.U
Summary
Their RNA was extracted from peripheral blood cells and reverse transcribed into cDNA which was amplified using real time PCR to measure the ratio of BCR-ABL fusion gene in their كروموسوم فیلادلفیا، الكلیفك، الھیدروكسي یوریا، تفاعل البلمرة المتسلسل، ابیضاض الدم النقیاني المزمن:الكلمات المفتاحیة
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