Department of Pathology, Division of Hematopathology, 5788 University Avenue, Mackenzie Building, Capital District Health Authority, Halifax, NS, B3H 1V8 Canada.
J Mol Diagn. 2010 Mar;12(2):197-203. doi: 10.2353/jmoldx.2010.090046. Epub 2010 Jan 21.
Cytogenetic abnormalities play a major role in the prognosis of patients with chronic lymphocytic leukemia (CLL). Several methods have emerged to try to best identify these abnormalities. We used fluorescence in situ hybridization (FISH) to determine the frequency of cytogenetic changes in our CLL patient population. We also evaluated the effectiveness of multiplex ligation-dependent probe amplification (MLPA) in detecting these abnormalities. Sixty-two B-CLL patients and 20 healthy controls were enrolled, and FISH and MLPA analyses were performed on peripheral blood samples. Using FISH, genomic aberrations were found in 73% of patients and presented as follows: single 13q14.3 deletion (60%), trisomy 12 (7%), ATM deletion (6%), 17p13.1 deletion (2%). MLPA analyses done on 61/62 patients showed sensitivity and specificity values of 90% and 100% respectively. MLPA revealed several additional copy number changes, the most common being 19p13 (LDLR and CDKN2D). Moreover, the cost for MLPA analysis, including technical time and reagents, is 86% less than FISH. In conclusion, cytogenetic abnormalities are a common finding in CLL patients, and MLPA is a reliable approach that is more cost effective and faster than FISH. Despite MLPA limitations of sensitivity, it can be used as a first-line screen and complementary test to FISH analysis.
细胞遗传学异常在慢性淋巴细胞白血病(CLL)患者的预后中起着重要作用。已经出现了几种方法来尝试最好地识别这些异常。我们使用荧光原位杂交(FISH)来确定我们的 CLL 患者群体中细胞遗传学变化的频率。我们还评估了多重连接依赖性探针扩增(MLPA)在检测这些异常方面的有效性。纳入了 62 例 B-CLL 患者和 20 名健康对照者,并对其外周血样本进行了 FISH 和 MLPA 分析。使用 FISH 发现 73%的患者存在基因组异常,表现为:单个 13q14.3 缺失(60%)、三体 12(7%)、ATM 缺失(6%)、17p13.1 缺失(2%)。对 61/62 例患者进行的 MLPA 分析显示,其敏感性和特异性值分别为 90%和 100%。MLPA 揭示了几个额外的拷贝数变化,最常见的是 19p13(LDLR 和 CDKN2D)。此外,MLPA 分析的成本,包括技术时间和试剂,比 FISH 低 86%。总之,细胞遗传学异常是 CLL 患者的常见发现,MLPA 是一种可靠的方法,比 FISH 更具成本效益和更快。尽管 MLPA 的敏感性有限,但它可以用作 FISH 分析的一线筛查和补充测试。