Phytohemagglutinin-Induced Peripheral Blood Cytogenetics: A Valid Means for Diagnosis and Imatinib Therapy Monitoring of Chronic Phase Chronic Myeloid Leukemia Patients

Abstract

Background: Conventional cytogenetic studies have been viewed as the standard follow-up method for Chronic Myeloid Leukemia patients on Imatinib. However, this approach is beset with high probability of poor metaphase index. In this study, we evaluated the application of Phytohemagglutinin (PHA)-induced peripheral blood culture based cytogenetic analysis (Karyotyping) in diagnosis and Imatinib treatment monitoring of the Chronic Phase CML patients. Methods: The patient samples were subjected to the PHA-induced peripheral blood culture based cytogenetic technique (Karyotyping) to establish their baseline cytogenetic status followed by their follow up Karyotyping twice at the end of 3 and 6 months of treatment. The simultaneous quantitative PCR (q-PCR) assay for BCR-ABL fusion gene transcript on the samples corresponding to their baseline as well as the follow up cytogenetic status was also carried out to authenticate the cytogenetic findings. Results: Complete Cytogenetic Response (CCR) and Partial Cytogenetic Response (PCR) was initially observed in 09 (30%) and 16 (53.3%) respectively of 30 CML patients with 05 (16.6%) patients showing no such response at the end of 3 months. At 6 months, 25 (83.3%) and 02 (6.6%) showed CCR and PCR respectively with 03 (10%) of patients without any response. The findings completely correlated with the hematological response, the q-PCR assay as well as the overall disease condition observed in the patients. Conclusion: As acquiring bone-marrow sample involves morbid consequences for patients and metaphases yielded thereby are difficult to analyze, PHA-induced peripheral blood Karyotyping was explored as an alternative. It was found to have significant potential in serving as a valid tool in the diagnosis and assessment of follow up response to Imatinib mesylate treatment of patients with chronic phase CML.