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Romero-Morelos P, González-Yebra AL, Muñoz-López D, Lara-Lona E, González-Yebra B. Frequencies of BCR::ABL1 Transcripts in Patients with Chronic Myeloid Leukemia: A Meta-Analysis. Genes (Basel) 2024; 15:232. [PMID: 38397221 PMCID: PMC10888370 DOI: 10.3390/genes15020232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 01/30/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
Chronic myeloid leukemia (CML) is associated with the Philadelphia chromosome and distinct BCR::ABL1 gene transcripts. We assessed the frequencies of these transcripts in Mexico, Latin America, and worldwide. We determined the prevalence of BCR::ABL1 transcripts in CML patients and intercontinental or regional variations using specialized databases and keywords. We analyzed 34 studies from 20 countries, encompassing 5795 patients. Keyword-based searches in specialized databases guided data collection. ANOVA was employed for transcript distribution analysis. The b3a2 transcript was most prevalent globally, followed by b2a2, with e1a2 being the least frequent. Interestingly, Mexico City exhibited a higher incidence of b2a2, while b3a2 predominated in the remaining country. Overall, no significant intercontinental or regional variations were observed. b3a2 was the most common BCR::ABL1 transcript worldwide, with b2a2 following closely; e1a2 was infrequent. Notably, this trend remained consistent in Mexico. Evaluating transcript frequencies holds clinical relevance for CML management. Understanding the frequency of transcript informs personalized CML treatments.
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Affiliation(s)
- Pablo Romero-Morelos
- Department of Research, State University of the Valley of Ecatepec, Ecatepec 55210, Mexico State, Mexico
| | - Ana Lilia González-Yebra
- Department of Applied Sciences to Work, Division of Health Sciences, University of Guanajuato, Campus León, León 37320, Guanajuato, Mexico;
| | - Daniela Muñoz-López
- Department of Medicine and Nutrition, Division of Health Sciences, University of Guanajuato, Campus León, León 37320, Guanajuato, Mexico; (D.M.-L.); (E.L.-L.)
| | - Elia Lara-Lona
- Department of Medicine and Nutrition, Division of Health Sciences, University of Guanajuato, Campus León, León 37320, Guanajuato, Mexico; (D.M.-L.); (E.L.-L.)
| | - Beatriz González-Yebra
- Department of Medicine and Nutrition, Division of Health Sciences, University of Guanajuato, Campus León, León 37320, Guanajuato, Mexico; (D.M.-L.); (E.L.-L.)
- Research Unit, Bajío Regional High Specialty Hospital, León, Guanajuato, Blvd. Milenio, Col, San Carlos, León 37544, Guanajuato, Mexico
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Huho AN, Issaq N, Iacobas I, Elghetany TM, López-Terrada D, Fisher KE, Punia JN. A Rare Case of Pediatric Chronic Myelogenous Leukemia Presenting With Severe Thrombocytosis Without Leukocytosis. Pediatr Dev Pathol 2018; 21:100-104. [PMID: 29187020 DOI: 10.1177/1093526617698601] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Pediatric chronic myelogenous leukemia is uncommon. We report a pediatric patient with chronic myelogenous leukemia presenting with a normal white blood cell count and no circulating immature myeloid cells. The patient presented with extreme thrombocytosis (platelet count range: 2175-3064 × 109/L) noted incidentally. No splenomegaly was found. Examination of the bone marrow aspirate revealed normal cellularity and normal myeloid: erythroid ratio with marked megakaryocytic hyperplasia. Molecular studies on the bone marrow aspirate detected both the major BCR/ABL1 p210 fusion transcript (9280 copies; p210/ ABL1 ratio: 38.2%) and the minor p190 transcript (below limit of quantitation). The platelet count normalized within 2 weeks after treatment with the second-generation tyrosine kinase inhibitor dasatinib. Follow-up after 3 months revealed a 1.87 log reduction in p210 transcripts compared to diagnosis and no detectable p190 transcripts. This case highlights the need to include BCR/ABL1 fusion testing to accurately diagnose pediatric patients presenting with isolated thrombocytosis.
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Affiliation(s)
- Albert N Huho
- 1 Department of Pathology & Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Niveen Issaq
- 1 Department of Pathology & Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Ionela Iacobas
- 2 Texas Children's Cancer and Hematology Center, Texas Children's Hospital, Houston, Texas, USA
| | - Tarek M Elghetany
- 1 Department of Pathology & Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Dolores López-Terrada
- 1 Department of Pathology & Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Kevin E Fisher
- 1 Department of Pathology & Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Jyotinder N Punia
- 1 Department of Pathology & Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
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Hsiao HH, Liu YC, Tsai HJ, Hsu JF, Yang WC, Chang CS, Lin SF, 蕭惠樺, 劉益昌, 蔡慧珍, 許瑞峰, 楊文祺, 張肇松, 林勝豐. Additional chromosome abnormalities in chronic myeloid leukemia. Kaohsiung J Med Sci 2011; 27:49-54. [DOI: 10.1016/j.kjms.2010.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Accepted: 09/21/2010] [Indexed: 11/16/2022] Open
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Cesar JM, Cabello P, Ferro T, Navarro JL. Emergence of chronic myelogenous leukemia in a patient with primary thrombocythemia and absence of BCR/ABL rearrangement. ACTA ACUST UNITED AC 2006; 167:74-7. [PMID: 16682291 DOI: 10.1016/j.cancergencyto.2005.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2005] [Revised: 09/23/2005] [Accepted: 09/26/2005] [Indexed: 10/24/2022]
Abstract
A 65-year-old woman presented with clinical features of primary thrombocythemia (PT), and absence of the BCR/ABL fusion gene. She responded to hydroxyurea treatment, although after 1 year she required progressive increases in the dose. Six years later, she maintained a high platelet count despite hydroxyurea at 2 g/day and treatment was changed to anagrelide. After 3 weeks, both platelet and leukocyte counts increased. A karyotype study detected the Philadelphia chromosome in all of the 24 metaphases studied. Fluorescent in situ hybridization (FISH) analysis revealed the BCR/ABL rearrangement. The patient was treated with imatinib mesylate and achieved a normal platelet and leukocyte count in 3 weeks. Patients presenting clinical features of PT expressing the Ph chromosome or the BCR/ABL fusion gene have been well documented but, to our knowledge, this is the first report of evolution from typical PT to chronic myeloid leukemia.
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MESH Headings
- Aged
- Antineoplastic Agents/therapeutic use
- Benzamides
- Blood Platelets/drug effects
- Bone Marrow Cells/cytology
- Cells, Cultured
- Chromosomes, Human, Pair 22
- Chromosomes, Human, Pair 9
- Chronic Disease
- Dose-Response Relationship, Drug
- Female
- Fibrinolytic Agents/therapeutic use
- Fusion Proteins, bcr-abl/analysis
- Humans
- Hydroxyurea/therapeutic use
- Imatinib Mesylate
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Leukocytes/drug effects
- Piperazines/therapeutic use
- Pyrimidines/therapeutic use
- Quinazolines/therapeutic use
- Thrombocythemia, Essential/complications
- Thrombocythemia, Essential/diagnosis
- Thrombocythemia, Essential/drug therapy
- Time Factors
- Translocation, Genetic
- Treatment Outcome
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Affiliation(s)
- Jesus M Cesar
- Department of Haematology, Hospital Ramon y Cajal, Ctera Colmenar Km 9,1, 28034 Madrid, Spain.
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Abstract
Chronic myeloid leukaemia (CML) is caused by the product of the BCR-ABL oncogene, located on the Philadelphia (Ph) chromosome. BCR-ABL is generated as a result of a reciprocal t(9;22) chromosomal translocation. The mechanisms responsible for this illegitimate recombination event remain elusive but are presumed to require a close spatial association of the translocation partners (chromosomes 9 and 22). BCR-ABL fusion transcripts can be detected by a sensitive reverse transcription-polymerase chain reaction (RT-PCR) in the leucocytes of some healthy individuals suggesting that chromosomal translocations may occur frequently in the general population. The presence of BCR-ABL fusion transcripts does not imply that the individual will inevitably develop CML since other conditions must be favourable for expansion of the abnormal clone. Breakpoints in the ABL gene occur within a 5' segment. BCR-ABL fusion transcripts lack ABL exon a1 and consist of BCR exons fused directly to ABL exon a2. The breakpoints in the BCR gene on chromosome 22 are found within three defined regions. Depending on the position of the BCR breakpoint, fusion genes are generated that encode 190-, 210- or 230-kD forms of the Bcr-Abl tyrosine kinase. Since the ABL component of the fusion gene is largely invariant, it follows that variability in disease phenotype may be due to protein sequences encoded by the translocation partner, BCR. Different disease phenotypes are associated with each of the three Bcr-Abl oncoproteins, p190(Bcr-Abl), p210(Bcr-Abl )and p230(Bcr-Abl). Mechanisms associated with malignant transformation include altered cellular adhesion, activation of mitogenic signalling pathways, inhibition of apoptosis and proteasomal degradation of physiologically important cellular proteins. CML is subject to an inexorable progression from an 'indolent' chronic phase to a terminal blast crisis. Disease progression is presumed to be associated with the phenomenon of genomic instability.
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MESH Headings
- Apoptosis
- Chromosome Breakage
- Fusion Proteins, bcr-abl/genetics
- Fusion Proteins, bcr-abl/metabolism
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Peptide Hydrolases/metabolism
- Signal Transduction
- Translocation, Genetic
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Affiliation(s)
- David J Barnes
- Department of Haematology, Faculty of Medicine, Imperial College of Science, Technology & Medicine, Hammersmith Hospital, London, UK
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Tiribelli M, Michelutti A, Damante G, Pellizzari L, Martinelli G, Amabile M, Russo D. Screening of Bcr-Abl transcripts in Philadelphia negative essential thrombocythemia. Leuk Lymphoma 2000; 39:339-41. [PMID: 11342314 DOI: 10.3109/10428190009065833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Essential thrombocythemia (ET) is a chronic myeloproliferative disorder characterised by the absence of the Philadelphia (Ph+) chromosome. Recent studies have reported controversial results relating to BCR-ABL rearrangements in ET patients. We studied 44 Ph-negative ET patients with the RT-PCR technique at diagnosis or during the follow-up. None of them showed any of the BCR-ABL transcript actually described by others in ET; neither the "classical" P210 nor the P190 or P230 variants. Our results confirm the absence of BCR-ABL abnormalities in Ph-negative ET patients.
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Affiliation(s)
- M Tiribelli
- Chair and Division of Hematology, Department of Medical and Morphological Research, University of Udine, Italy
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