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Sharma D, Wilson C, Kumar S, Ghose S, Sahoo R, Sharawat SK. Does presence of complex translocations involving BCR::ABL1 in chronic myeloid leukemia affect the response rate to tyrosine kinase inhibitors? A systematic review of the literature. Ann Diagn Pathol 2024; 71:152303. [PMID: 38636337 DOI: 10.1016/j.anndiagpath.2024.152303] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/02/2024] [Accepted: 04/06/2024] [Indexed: 04/20/2024]
Abstract
Philadelphia (Ph) chromosome (9;22)(q34;q11) comprises 90-95 % of chronic myeloid leukemia (CML), while 5-10 % of CML have translocations involving three or more chromosomes. The outcome of treating patients harbouring complex Ph-positive cytogenetics with tyrosine kinase inhibitors (TKI) is unclear. In the present systematic review, we aim to summarise the response of patients with complex Ph-positive cytogenetics to treatment with TKI therapy. We collated all available literature from databases such as PubMed, Google Scholar, Web of Science database, Cochrane library, Scopus and Embase (up until January 31st, 2024), which describe cases of patients with CML, harbouring complex Ph-positive variations (three and four-way translocations), and summarised their response to TKI therapy. The studies were screened for the following criteria: documented TKI intervention and outcome (whether CR was achieved). Studies that did not report the same, were excluded. Additionally, we report a case from our center of a 55-year-old patient with CML, positive for the Ph-chromosome, harbouring a three-way translocation involving chromosome 15 i.e. 46XX, t(9;15;22) (q34;p11;q11). Identification of BCR::ABL and involvement of chromosome 15 was carried out using conventional cytogenetics, fluorescence in situ hybridization (FISH), and quantitative PCR (qPCR). Based on the inclusion criteria, a total of 15 studies were included from which a total of 87 cases were covered. Overall, we identified 38 unique complex three- and four-way translocations across 87 Ph-positive cases and found that 85 patients with complex Ph-positive cytogenetics achieved complete remission upon treatment and did not appear to have a lesser response to TKI therapy.
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Affiliation(s)
- Diwakar Sharma
- Department of Medical Oncology, Dr.B.R.A. I.R.C.H., All India Institute of Medical Sciences, New Delhi, India
| | - Christine Wilson
- Department of Medical Oncology, Dr.B.R.A. I.R.C.H., All India Institute of Medical Sciences, New Delhi, India
| | - Sachin Kumar
- Department of Medical Oncology, Dr.B.R.A. I.R.C.H., All India Institute of Medical Sciences, New Delhi, India
| | - Sampa Ghose
- Department of Medical Oncology, Dr.B.R.A. I.R.C.H., All India Institute of Medical Sciences, New Delhi, India
| | - Ranjit Sahoo
- Department of Medical Oncology, Dr.B.R.A. I.R.C.H., All India Institute of Medical Sciences, New Delhi, India
| | - Surender K Sharawat
- Department of Medical Oncology, Dr.B.R.A. I.R.C.H., All India Institute of Medical Sciences, New Delhi, India.
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Varga J, Reviczká A, Háková H, Švajdler P, Rabajdová M, Ostró A. Predictive factors of endometriosis progression into ovarian cancer. J Ovarian Res 2022; 15:5. [PMID: 35012617 PMCID: PMC8751310 DOI: 10.1186/s13048-021-00940-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years, the endometriosis has overcome a noteworthy renaissance in the recognition of its potential. In certain patients, a demonstrable malignant progression of ectopic foci leading to development of ovarian cancer is seen. The knowledge of endometriosis overthrow background into endometriosis associated ovarian cancer is of paramount importance for selection of patients at risk. The goal of the presented study was to review a malignant potential of the endometriosis and to specify predictive factors of endometriosis progression into ovarian cancer. Altogether 189 patients were included in the study. Conventional cytogenetics as well as measurement of transcriptional activity of CTNNB1 (β-catenin) and HIF1A (HIF1-α) genes were prospectively studied in 60 endometriosis patients and 50 control group patients. The retrospective histopathological analysis was performed in 19 endometriosis associated ovarian cancer patients and 60 patients with histologically confirmed endometriosis. RESULTS Five endometriosis patients showed a deviation from normal cytogenetics finding without affecting of their phenotype. In 6 cases of endometriosis associated ovarian cancer ectopic endometrium was not confirmed. The remaining 13 cases demonstrated either benign or atypical endometriosis or even structures of borderline carcinoma. Atypical endometriosis was histologically confirmed in 20% of 60 endometriosis patients. Determination of gene expression (CTNNB1, HIF1A) formed two subgroups. Transcriptionally incipient endometriosis subgroup with insignificant genes expression compared to control group. In transcriptionally evident endometriosis subgroup were genes expressions significantly higher compared to control group (p < 0.01) as well as transcriptionally incipient endometriosis subgroup (p < 0.05). CONCLUSIONS Significant structural abnormalities of chromosomes are not included in genetic rigging of endometriosis patients. Atypical endometriosis represents a histopathologically detectable intermediate of endometriosis progression. Determination of genes expression CTNNB1 and HIF1A helps to allocate risk patients with endometriosis where more precise management is needed.
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Affiliation(s)
- Ján Varga
- Department of Gynaecology and Obstetrics, Faculty of Medicine, P.J. Šafárik University and L. Pasteur University Hospital, Rastislavova 43 Street, 041 90, Košice, Slovakia.
| | - Alžbeta Reviczká
- Frauenklinik, DONAUISAR Klinikum Deggendorf, Deggendorf, Germany
| | - Hedviga Háková
- Department of Laboratory Medicine, subdivision of Medical Genetics L. Pasteur University Hospital, Košice, Slovakia
| | | | - Miroslava Rabajdová
- Department of Medical and Clinical Biochemistry, Faculty of Medicine, P. J. Šafárik University, Košice, Slovakia
| | - Alexander Ostró
- Department of Gynaecology and Obstetrics, Faculty of Medicine, P.J. Šafárik University and L. Pasteur University Hospital, Rastislavova 43 Street, 041 90, Košice, Slovakia
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Ankathil R, Foong E, Siti-Mariam I, Norhidayah R, Nazihah MY, Sangeetha V, Hariharan S, Azlan H. Hyperdiploid Multiple Myeloma with Novel Complex Structural Chromosome Abnormalities Associated with Poor Prognosis : A Rare Case Report. Int J Hematol Oncol Stem Cell Res 2021; 15:199-205. [PMID: 35083001 PMCID: PMC8748240 DOI: 10.18502/ijhoscr.v15i3.6852] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 05/11/2020] [Indexed: 12/24/2022] Open
Abstract
Hyperdiploid multiple myeloma (MM) is associated with better prognosis and non-hyperdiploid subtype is associated with variable to adverse prognosis based on the nature of karyotype abnormality. Rarely exceptions to this hyperdiploid and non-hyperdiploid divisions do exist in a minority. We report an adult male MM patient who showed hyperdiploid karyotype with few novel complex abnormalities and who showed poor clinical outcome. Conventional cytogenetic analysis carried out in 22 GTG banded metaphases showed 53,Y,der(X)t(X;22)(q27;q11.2),+3,+5,+6,+9,+11,+15,der(17)ins(17;1;3)(q11.2;?;?),der(17)ins(17;1;3)(q11.2;?;?),+19,-22,+mar karyotype pattern in 15 metaphases whereas 7 metaphases showed 46,XY karyotype pattern. Interphase FISH revealed biallelic del(13q14) and del(17p13) but no translocations involving the 14q32 region. Through Spectral karyotyping FISH, the origin of complex abnormalities involving der(17) chromosome, translocation t(X;22), and marker chromosome could be clearly delineated. Although the present case showed hyperdiploid karyotype, he showed an adverse prognosis probably due to the co-existence of high risk and complex abnormalities and expired 5 months after initial diagnosis despite standard treatment given.
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Affiliation(s)
- Ravindran Ankathil
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Eva Foong
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Ismail Siti-Mariam
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Ramli Norhidayah
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Mohd Yunus Nazihah
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Vijay Sangeetha
- Regional Cancer Centre, Medical College, Thiruvananthapuram, Kerala, India
| | | | - Husin Azlan
- Department of Internal Medicine and Clinical Hematology, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Tashfeen S, Mahmood R, Khan SA, Khadim T. Additional chromosomal abnormalities in Philadelphia positive chronic myeloid leukemia. Pak J Med Sci 2019; 36:208-212. [PMID: 32063961 PMCID: PMC6994891 DOI: 10.12669/pjms.36.2.1384] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To determine the frequency of additional chromosomal abnormalities in Philadelphia chromosome positive Chronic Myeloid Leukemia (CML) by conventional cytogenetic analysis. Methods This descriptive cross sectional study was conducted at Armed Forces Institute of Pathology (AFIP), Rawalpindi, from January 2012 to December 2016. A total number of 528 newly diagnosed CML patients were included in the study. The subjects were tested for the presence of Philadelphia (Ph) chromosome and other additional cytogenetic abnormalities by conventional cytogenetic analysis interpreted according to International System of Human Cytogenetic Nomenclature (ISCN) criteria. Molecular analysis for BCR-ABL was also performed for each patient. The additional cytogenetic abnormalities were then classified into major route abnormalities and minor route abnormalities. Results Out of the 528 newly diagnosed CML patients, 378 (71.6%) were males and 150 (28.4%) were females. The age of patients ranged between 18 to 74 years. Four hundred and ninety-eight (94.3%) patients showed Philadelphia chromosome on karyotyping while 30 (5.7%) were negative for the Philadelphia chromosome. On analysis of these 498 Philadelphia positive patients, additional cytogenetic aberrations were detected in 26 (4.9%) patients. Of these, 7 (1.3%) had major route abnormalities while 19 (3.6%) had minor route abnormalities. Conclusion The frequency of additional chromosomal abnormalities in our study were not in accordance with previous local and international studies.
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Affiliation(s)
- Sunila Tashfeen
- Dr. Sunila Tashfeen, FCPS. Department of Pathology, Combined Military Hospital, Quetta, Pakistan
| | - Rafia Mahmood
- Dr. Rafia Mahmood, FCPS. Armed Forces Institute of Pathology, Rawalpindi, Pakistan
| | - Saleem Ahmed Khan
- Dr. Saleem Ahmed Khan, FCPS, Ph D Haematology, Army Medical College, Rawalpindi, Pakistan
| | - Tahir Khadim
- Dr. Tahir Khadim, FCPS. Armed Forces Institute of Pathology, Rawalpindi, Pakistan
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Onur Cura D, Bora E, Ozkalayci H, Kirbiyik O, Kutbay YB, Ercal D, Cankaya T. Unexpected Coexistence of a Derivative t(21;21) and Complementary Mosaic r(21) in a Female with Multiple Miscarriages. Cytogenet Genome Res 2019; 158:83-87. [PMID: 31195399 DOI: 10.1159/000500986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2019] [Indexed: 11/19/2022] Open
Abstract
The case presented here describes a female patient with recurrent miscarriages and a normal microarray analysis result. However, the coexistence of a robertsonian (21;21) translocation and complementary mosaic ring chromosome 21 was detected by karyotyping and FISH analysis. Partial trisomy 21 was found with QF-PCR and microarray analysis in one of the fetuses. The aim of this report was to emphasize the diagnostic importance of conventional cytogenetics.
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Abstract
Multiple myeloma is a heterogeneous disease. Its chromosomal abnormalities have been extensively studied with a view to accurate prognostication and personalized therapy. Here, we describe the techniques commonly employed for elucidating chromosomal aberrations, prognostic impact of recurrent chromosomal abnormalities, and recently updated risk stratification systems.
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Affiliation(s)
- Nelson Chun Ngai Chan
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, Hong Kong.
| | - Natalie Pui Ha Chan
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, Hong Kong
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Devi GS, Ahmed F, Mundada MC, Murthy SS, Mallavarapu KM. A Case of AML-M2 with Sole Interstitial Deletion in 9q Without AML1-ETO/Inv 16 Rearrangement and FLT3/NPMI Mutations. Indian J Hematol Blood Transfus 2014; 30:186-9. [PMID: 25332574 DOI: 10.1007/s12288-013-0322-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 12/24/2013] [Indexed: 11/27/2022] Open
Abstract
Conventional/molecular cytogenetics is important in identification of genomic abnormalities, for prognostication and in risk stratification of de novo patients with acute myeloid leukemias (AML). Here we present an AML M2 case showing the sole karyotypic abnormality, the rare interstitial deletion in the long arm of chromosome 9 with the loss of segment q12-q13.
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