Department of Physiology, College of Medicine, Al-Nahrain University, Baghdad, Iraq.
Medical Research Unit, College of Medicine, Al-Nahrain University, Baghdad, Iraq.
Mol Genet Genomic Med. 2019 Aug;7(8):e809. doi: 10.1002/mgg3.809. Epub 2019 Jun 17.
Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of BCR-ABL fusion gene (GenBank accession NC_000022.11). In the vast majority of CML patients, the typical subtype of BCR-ABL transcript are b3a2, b2a2 or both. The aim of this study was to determine the different subtypes of BCR-ABL transcript and their impact on the demographic and hematological parameters in Iraqi patients with CML.
One hundred patients with chronic phase CML (11 newly diagnosed and 89 imatinib-resistant) were enrolled in this study. Ribonucleic acid (RNA) was extracted from leukocytes, and complementary DNA was created using reverse transcriptase polymerase chain reaction technique. A multiplex polymerase chain reaction with four specific primers was used to determine the BCR-ABL fusion subtypes in each patient.
Male to female ratio was 1.38:1. Fifty-nine patients expressed b3a2 transcript, whereas 39 of the remaining cases were positive for b2a2 variant. One case expressed b2a3 transcript, while the last case coexpressed the two subtypes of mRNA b3a2/b2a2. Male and female were significantly associated with b3a2 and b2a2 subtypes, respectively. The b3a2 subtype showed higher total leukocyte count than b2a2 subgroup, while b2a2 variant demonstrated significantly elevated platelet counts compared to those with b3a2 transcript. A significantly higher plateletcrit percentage (PCT%) was found in patients with b2a2 transcript whereas.
The testified Iraqi group expressed M-BCR-ABL type with preponderance of b3a2 over b2a2 subtype. There was a gender-skewed distribution in BCR-ABL transcript types with b3a2 transcript more prevalent in males. The type of BCR-ABL transcript is reflected by different leukocyte and platelet counts at diagnosis, which might represent a distinct phenotype and disease biology.
慢性髓性白血病（CML）是一种骨髓增生性肿瘤，其特征是存在 BCR-ABL 融合基因（GenBank 登录号 NC_000022.11）。在绝大多数 CML 患者中，BCR-ABL 转录本的典型亚型为 b3a2、b2a2 或两者兼有。本研究旨在确定 BCR-ABL 转录本的不同亚型及其对伊拉克 CML 患者的人口统计学和血液学参数的影响。
本研究纳入了 100 例慢性期 CML 患者（新诊断的 11 例和伊马替尼耐药的 89 例）。从白细胞中提取核糖核酸（RNA），并使用逆转录酶聚合酶链反应技术合成互补 DNA。使用四个特定引物的多重聚合酶链反应来确定每位患者的 BCR-ABL 融合亚型。
男女比例为 1.38:1。59 例患者表达 b3a2 转录本，而其余 39 例患者为 b2a2 变体阳性。1 例患者表达 b2a3 转录本，而最后 1 例患者同时表达 b3a2 和 b2a2 两种亚型的 mRNA。男性和女性与 b3a2 和 b2a2 亚型分别显著相关。b3a2 亚型的总白细胞计数高于 b2a2 亚组，而 b2a2 变体的血小板计数明显高于 b3a2 转录本的患者。b2a2 转录本患者的血小板比容百分比（PCT%）显著升高，而 b3a2 转录本患者的血小板比容百分比则显著降低。
经证实的伊拉克组表达 M-BCR-ABL 型，b3a2 亚型多于 b2a2 亚型。BCR-ABL 转录本的类型存在性别偏倚分布，b3a2 转录本在男性中更为常见。诊断时的 BCR-ABL 转录本类型反映了不同的白细胞和血小板计数，这可能代表了一种不同的表型和疾病生物学。
