Azad Niyaz A, Shah Zafar A, Pandith Arshad A, Khan Mosin S, Rasool Roohi, Rasool Javed, Aziz Shiekh A
Department of Immunology and Molecular Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India. Email:
Asian Pac J Cancer Prev. 2018 Jun 25;19(6):1479-1485. doi: 10.22034/APJCP.2018.19.6.1479.
Background: The prognostic significance of the common BCR-ABL transcripts like e13a2 (b2a2) and e14a2 (b3a2) in Chronic myeloid leukemia (CML) has been reported from patients treated with different tyrosine kinase inhibitors but its impact on clinical response and overall survival remains still unexplored. The aim of this study was to evaluate the prognostic significance of different transcript types in a cohort of CML patients treated with imatinib. Methods: A total 42 confirmed cases of Chronic Myeloid Leukemia (CML) patients were recruited into our cohort study and a multiplex Reverse Transcriptase-Polymerase Chain Reaction technique (RT-PCR) was used to detect 3 main transcript types ‘e1a2’, ‘e13a2’, and ‘e14a2’ found in CML. Results: Only two types of transcripts e13a2 (b2a2) and e14a2 (b3a2) were detected in our CML patients and none had the e1a2 type. All the patients were RT-PCR positive for either e13a2 or e14a2 fusion transcript demonstrating 100% concordance with their Ph+ve cytogenetic status at baseline. TLC count (range of 201-600x103/μl) and platelet count (range of 201-900x103/μl) at baseline were found to be associated more with the e14a2 (b3a2) than the e13a2 (b2a2) transcript type (p-value: 0.001). The two transcripts found did not relate significantly towards sex, age-group or indicated spleen size ranges as well as percentage ranges of blast cells. Conclusion: We conclude that there is no overall prognostic implication of either the e13a2 or the e14a2 transcript type across the spectrum of indicated clinical parameters evaluated. Even the overall survival analysis of the two transcript types revealed no prognostic association whatsoever.
不同酪氨酸激酶抑制剂治疗的慢性髓性白血病（CML）患者中，常见的BCR-ABL转录本如e13a2（b2a2）和e14a2（b3a2）的预后意义已有报道，但其对临床反应和总生存期的影响仍未明确。本研究旨在评估伊马替尼治疗的CML患者队列中不同转录本类型的预后意义。方法：共42例确诊的慢性髓性白血病（CML）患者纳入我们的队列研究，采用多重逆转录聚合酶链反应技术（RT-PCR）检测CML中发现的3种主要转录本类型“e1a2”、“e13a2”和“e14a2”。结果：我们的CML患者中仅检测到两种转录本类型e13a2（b2a2）和e14a2（b3a2），无一例为e1a2类型。所有患者的e13a2或e14a2融合转录本RT-PCR均为阳性，与基线时的Ph+细胞遗传学状态100%一致。发现基线时白细胞计数（范围为201-600×10³/μl）和血小板计数（范围为201-900×10³/μl）与e14a2（b3a2）转录本类型的相关性高于e13a2（b2a2）转录本类型（p值：0.001）。发现的这两种转录本与性别、年龄组、脾脏大小范围或原始细胞百分比范围均无显著相关性。结论：我们得出结论，在所评估的一系列临床参数中，e13a2或e14a2转录本类型均无总体预后意义。甚至这两种转录本类型的总生存期分析也未显示出任何预后关联。
