Original Research ARTICLE
Impact of Additional Chromosomal Aberrations on the Disease Progression of Chronic Myelogenous Leukemia
- 1Regional Cancer Center Thiruvananthapuram, India
- 2PSG College of Arts and Science, India
The emergence of additional chromosomal abnormalities (ACAs) in Philadelphia chromosome/BCR-ABL1 positive chronic myeloid leukemia (CML) is considered to be a feature of disease evolution. However, their frequency of incidence, impact on prognosis and treatment response effect in CML is not conclusive. In the present study, we performed chromosome analysis of 489 patients in different clinical stages of CML by conventional GTG-banding, Fluorescent In Situ Hybridization and Spectral Karyotyping. Among the de novo CP cases, ACAs were observed in 30 patients (10.20%) with lowest incidence, followed by IM resistant CP (16.66%) whereas in AP and BC, the occurrence of ACAs were higher and it were about 40.63% and 50.98% respectively. The frequency of occurrence of ACAs were compared between the study groups and found that the incidence of ACAs were higher in BC compared to de novo and IM resistant CP cases. Likewise, it was higher in AP patients when compared between de novo and IM resistant CP cases, mirroring the fact that cytogenetic evolution with disease progression in CML. In addition, we observed 10 novel and 10 rare chromosomal aberrations among the study subjects. This study pinpoints the fact that the genome of the advanced phase patients were highly unstable and this environment of genomic instability is responsible for the high occurrence of ACAs. Treatment response analysis revealed that compared to initial phases, ACAs were associated with adverse prognostic effect during the progressive stages of CML. This study further portrayed the cytogenetic mechanism of disease evolution in CML.
Keywords: Additional chromosomal abnormalities, variant Ph translocation, Spectral Karyotyping, blast crisis CML, Fluorescent in situ hybridization
Received: 12 Dec 2018;
Accepted: 30 Jan 2019.
Edited by:Alessandro Gozzetti, University of Siena, Italy
Reviewed by:Fabio Stagno, Azienda Ospedaliero-Universitaria Policlinico - Vittorio Emanuele, Italy
Elisabetta Abruzzese, Independent researcher
Copyright: © 2019 Krishna Chandran, Geetha, Sakthivel, Suresh Kumar, Jagathnath Krishna and Sreedharan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dr. Hariharan Sreedharan, Regional Cancer Center Thiruvananthapuram, Thiruvananthapuram, 695011, Kerala, India, firstname.lastname@example.org