scholarly journals Philadelphia chromosome detection in chronic myeloid leukemia: Utility of phytohemagglutinin-stimulated peripheral blood culture

2012 ◽  
Vol 55 (2) ◽  
pp. 196
Author(s):  
Neelam Varma ◽  
KamerSingh Rana ◽  
Subhash Varma ◽  
ManUpdesh Singh Sachdeva
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Blood Culture ◽  
Peripheral Blood ◽  
Myeloid Leukemia ◽  
Philadelphia Chromosome ◽  
Peripheral Blood Culture

scholarly journals Atypical Chronic Myeloid Leukemia

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5455-5455
Author(s):  
Chandralekha Ashangari ◽  
Praveen K. Tumula
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Peripheral Blood ◽  
Myeloid Leukemia ◽  
Conflicts Of Interest ◽  
Philadelphia Chromosome ◽  
Myeloproliferative Neoplasm ◽  
Peripheral Blood Flow ◽  
Current Standard ◽  
Atypical Chronic Myeloid Leukemia ◽  
Wbc Count

Abstract Introduction: Atypical chronic myeloid leukemia (aCML), BCR-ABL1 negative is a rare myelodysplastic syndromes (MDS)/myeloproliferative neoplasm (MPN) for which no current standard of care exists. We present one of the rare presentations of aCML in an elderly patient. Case: A 76 year old male presented to the Hematology clinic for consultation after discharge from local hospital for elevated WBC count. Past medical history was significant for COPD, acid reflux, peripheral arterial disease and hypertension. Physical exam was unremarkable. Initial labs were significant for leukocytosis of 30 k/cu mm, anemia with Hb 10 gm/dl, thrombocytosis 695,000 with neutrophilia of ANC 25,200. Peripheral blood was negative for JAK2 V617F and BCR-ABL. Peripheral blood flow cytometry showed granulocytic left shift with 1.5% myeloblasts. Bone marrow biopsy suggestive of hypercellular marrow (100%) with myeloid predominance, atypical megakaryocytes, increased ring sideroblasts (49% of NRBC), increased blasts (5%) and dysgranulopoeisis over all suggestive of Myelodyplastic Syndrome/Chronic Myeloproliferative Disorder (MDS/MPD). Cytogenetics were positive for U2AF1 positive, CSF3R T6181, CSF3R Q776 pathognomonicof atypical CML and negative for BCR-ABL, FLT3. He was considered transplant ineligible. He was started on Azacitadine and is currently receiving 2nd cycle therapy. He is also receiving darbepoeitin periodically to avoid frequent transfusions. He is currently transfusion independent. Discussion: Increased WBC count (e.g., cutoffs of >40×109/L or 50×109/L), increased percentage of peripheral blood myeloid precursors, female sex, and older age are adverse prognostic factors for overall survival or leukemia-free survival in aCML. aCML cases lack in Philadelphia chromosome. Overall 50-65% of patients show cytogenetic abnormalities. The most frequent is +8 (25%). Other changes such as -7 and del(12p) have also been recurrently observed. Patients with aCML have an estimated median survival between 14 and 30 months. aCML tends to exhibit a more aggressive clinical course than other MDS/MPN subtypes. Figure. Figure. Disclosures No relevant conflicts of interest to declare.

Danusertib Hydrochloride (PHA-739358), a Multi-Kinase Aurora Inhibitor, Elicits Clinical Benefit in Advanced Chronic Myeloid Leukemia and Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia .

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 864-864 ◽  
Author(s):  
Jorge Cortes-Franco ◽  
Hervé Dombret ◽  
Philippe Schafhausen ◽  
Tim H Brummendorf ◽  
Nicolas Boissel ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Chronic Myeloid Leukemia ◽  
Peripheral Blood ◽  
Clinical Benefit ◽  
Myeloid Leukemia ◽  
Lymphoblastic Leukemia ◽  
Philadelphia Chromosome ◽  
Medical Sciences ◽  
2Nd Generation ◽  
Philadelphia Chromosome Positive

Abstract Abstract 864 Background: Despite the availability of novel ABL tyrosine kinase inhibitors ( TKI ) in addition to imatinib mesylate, the acquisition of the T315I BCR-Abl mutation remains a major cause of resistance to registered therapeutic compounds. Some patients (Pts) may also fail therapy with ≥ 2 TKI and need additional treatment. PHA-739358 is a small ATP competitive molecule that specifically inhibits Aurora A, B and C kinases. PHA-739358 possesses high affinity binding capacity to both wild-type Abl and Abl/T315I in in vitro assays. Methods: An international, multicenter, open-label, single agent, non-comparative, phase I study is being conducted in adult Pts with advanced Chronic Myeloid Leukemia (Accelerated AP-CML/Blastic phase BP-CML) and Philadelphia-Chromosome Positive Acute Lymphoblastic Leukemia (Ph+ ALL) resistant or intolerant to imatinib and/or 2nd generation c-Abl therapy. Primary objective of the study is to determine the Maximum Tolerated Dose (MTD) and the Dose Limiting Toxicity (DLTs) during the first cycle. Two schedules were planned. Schedule A (PHA-739358 given as daily 3-hrs iv infusion for 7 consecutive days, every 2 wks) is open. Schedule B, not yet started, foresees a more aggressive approach and is currently being amended. Results: Twenty-three Pts with CML and Ph+ ALL have been treated so far (4 with AP-CML; 8 with BP-CML and 11 with Ph+ALL). Five dose levels have been tested: 90 (N=7); 120 (N=4); 150 (N=6); 180 (N=3) and 200 (N=3) mg/m2. Only one DLT occurred at 90 mg/m2 (NCI-CTC AE Gr3 fainting). Presently the MTD has not been defined. Fifteen out of 23 Pts have confirmation of BCR-Abl T315I mutation. A response occurred in 6/14 Pts, including 3 cytogenetic (1 complete, 1 partial, 1 minimal), 5 hematologic, and 1 clinical improvement (reduction in extramedullary disease mass). One severely pretreated (chemotherapy+Imatinib, SCT, Dasatinib and Donor Lymphocyte Infusion) pt with T315I mutated Ph+ALL reached Complete Hematological Response since Cycle (Cy) 4, Complete Cytogenetic Response since Cy 8 and Molecular Response (BCR/ABL undetectable transcripts) since Cy 9. Treatment continues after 10+ months. Last cycles were given every 4 wks due to mild/moderate transaminitis. This Pt at baseline showed: Peripheral Blood Blasts=0%; Bone Marrow (BM) blasts= 33%; % of Ph+ Metaphases = 80%. Two additional Pts (AP-CML and Ph+ ALL) achieved cytogenetic responses, one minimal and one partial reached at Cy2 and Cys 1-6, respectively. Another Pt (BP-CML) who received multiple transplants (3 times) and progressed after Imatinib, Dasatinib, Bosutinib, Nilotinib and Homoharringtonine, with 4 cycles of PHA-739358 had significant improvement of a large extramedullary lesion in the left neck impeding breathing and swallowing. Significant but transient reduction in the White Blood Cells (8/13 pts) and peripheral blood blast counts (3/13 Pts) were obtained with PHA-739358. An acceptable tolerability and safety profile characterized the study therapy: max non-hematological tox (regardless of causality) was as follows (most frequent Adverse events ≥ 30 %): diarrhoea 57% (CTC Gr 3 one Pt), pyrexia 50%; headache 43% (CTC Gr 3 one Pt); dyspnoea 36% (CTC Gr 3 one Pt ) and nausea 36%. Data analysis ongoing. Conclusions: The preliminary results obtained with our study show that PHA-739358 can elicit significant response with clinical benefit in severely pretreated populations of Pts affected with advanced leukemias resistant/intolerant to Imatinib and other 2nd generation TKI. Disclosures: Schafhausen: Bristol-Myers Squibb: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Sanofi-Aventis: Speakers Bureau; Novartis: Speakers Bureau; Chugai Pharmaceutical: Speakers Bureau. Latini:Nerviano Medical Sciences: Employment. Capolongo:Nerviano Medical Sciences: Employment. Laffranchi:Nerviano Medical Sciences: Employment. Comis:Nerviano Medical Sciences: Employment.

BCR/ABL Fusion Gene On Constitutional Der(14;22) Roberstsonian Translocation in a Case of Chronic Myeloid Leukemia with Masked Philadelphia Chromosome

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4822-4822
Author(s):  
Pablo Lopez ◽  
Daniela Infante ◽  
Isabel Moro ◽  
Victoria Elizondo ◽  
Gerardo Romanelli ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Chronic Myeloid Leukemia ◽  
Peripheral Blood ◽  
Cytogenetic Analysis ◽  
Myeloid Leukemia ◽  
Robertsonian Translocation ◽  
Philadelphia Chromosome ◽  
Chromosome 9 ◽  
Ph Chromosome ◽  
One Step

Abstract Abstract 4822 Chronic myeloid leukemia (CML) is characterized by the Philadelphia chromosome (Ph) observed in more than 90% of patients with CML as a result of t(9;22)(q34;q11), leading to the formation of the BCR/ABL chimeric gene. The remaining 5–10% of CML cases exhibit a variant Ph translocation generally involving a third or even a fourth chromosome in addition to chromosome 9 and 22, potentially leading to masked Ph chromosome or reveal cryptic translocations that remains undetected under conventional cytogenetic analysis. These chromosome rearrangements can be disclosed by means of fluorescence in situhybridization (FISH) or polymerase chain reaction (PCR) procedures. A very few Ph positive CML cases were reported with constitutional robertsonian translocations, i.e. translocation between two acrocentric chromomosomes (13–15, 21–22), with breakpoints in the short arms, leading to a dicentric chromosome and thus to 45 instead of 46 chromosomes Case Report. 42 year-old woman presenting with asthenia. Physical examination: Grade 1 splenomegaly. Peripheral blood count showed: hemoglobin concentration 117g/L, platelet count: 329×109/L and white blood cell count (WBC): 199×109/L. Peripheral blood smear: myelemia exhibiting 3% of myeloid blasts. Cytogenetic analysis by G-banding performed on bone marrow metaphase cells afforded the following karyotype: 45, XX, der(14;22)(q10;q10)c?, t(9;22;11)(q34;q11;q13) [20]. The analysis of the BCR-ABLfusion gene according to standard protocols detected the presence of the b3a2 isoform. FISH studies using dual color dual fusion probes in metaphases showed a 1F2G2R signal pattern. We detect a normal ABL signal on chromosome 9 and BCR signal on chromosome 22; the fusion signal was present on the der(14;22);extra-signals BCR and ABL with reduced intensities were present on der(11) and der(9) respectively: ish der(9)(ABLdim+), der(11)(BCRdim+), der(14;22)(BCR+,ABL+) [10]. FISH analysis on interphase nuclei (n=200) presented the same signal pattern. Nuc ish (ABL, BCRx3)(BCR con ABL x1) [200]. Chromosome analysis of bone marrow cells after six months of Imatinib therapy showed the following karyotype: 45, XX, der(14;22)(q10;q10)c [20] thus demonstrating complete cytogenetic remission and that der(14;22) is a robertsonian constitutional abnormality that could be inherited and thus necessitate a familial genetic councelling to inform about the familial risk of congenital malformations and miscarriage. Discussion. To explain the formation of variant chromosome Ph translocations one-step, two-step and multi-step mechanisms have been proposed. In our case complex translocations involving four chromosomes and the participation of two acrocentric chromosomes, led to the hypothesis of the presence of a constitutional or acquired Robertsonian translocation. Karyotype analysis six months after treatment confirmed the presence of a constitutional Robertsonian translocation. According to the FISH pattern, this variant Ph chromosome was formed in one step. The occurrence of Philadelphia positive CML in a patient with a constitutional Robertsonian translocation is probably coincidental. The role of constitutional chromosomes abnormalities in hematologic malignancies is well known in Down syndrome patients and in chromosome breakage syndromes such as Fanconi anemia. In the literature, only one case of CML patients with Robertsonian t(14;22) have been described. To our knowledge this is the first report showing a Robertsonian t(14;22) in a variant Ph involving four chromosomes and exhibiting the fusion FISH signal in a derivative chromosome 14, with masked Ph. Disclosures: No relevant conflicts of interest to declare.

Philadelphia chromosome-positive thrombocythemia without features of chronic myeloid leukemia (CML) in peripheral blood

2005 ◽  
Vol 84 (6) ◽  
pp. 409-410 ◽  
Author(s):  
François Girodon ◽  
François Bailly ◽  
Marly Barry ◽  
Bernardine Favre ◽  
Paule-Marie Carli ◽  
...  
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Peripheral Blood ◽  
Myeloid Leukemia ◽  
Philadelphia Chromosome ◽  
Philadelphia Chromosome Positive

THE CASE VARIANT TRANSLOCATION T(3;9;22)(P24;Q34;Q11) IN CHRONIC MYELOID LEUKEMIA

2018 ◽  
Vol 64 (6) ◽  
pp. 810-814
Author(s):  
Kodirzhon Boboev ◽  
Yuliana Assesorova ◽  
Kh. Karimov ◽  
B. Allanazarova
Keyword(s):  
Adverse Effect ◽  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Fusion Gene ◽  
Genetic Locus ◽  
Philadelphia Chromosome ◽  
Chromosome 9 ◽  
Banding Technique ◽  
Variant Translocation

This paper presents a case of chronic myeloid leukemia with an earlier unknown variant translocation t (3; 9; 22) (p24; q34; q11) detected by cytogenetic research using the GTG-banding technique. Despite the absence of the classical Philadelphia chromosome, the presence of chromosome 9 and 22 derivatives, as well as the BCR-ABL fusion gene, allow this translocation to be considered pathogenetic for CML. A good response of the patient to the treatment with glivec is that there is no adverse effect on the pathogenesis of the disease of an additional genetic locus (3p24) involved in complex restructuring.

Effect of Dasatinib on Genes Related to Mitotic Catastrophe Pathway in Chronic Myeloid Leukemia Cells

2020 ◽  
Vol 20 ◽  
Author(s):  
Sezgi Kipcak ◽  
Buket Ozel ◽  
Cigir B. Avci ◽  
Leila S. Takanlou ◽  
Maryam S. Takanlou ◽  
...  
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Kinase Inhibitors ◽  
Fusion Gene ◽  
Philadelphia Chromosome ◽  
K562 Cells ◽  
Mitotic Catastrophe ◽  
Control Group ◽  
Cancer Therapies ◽  
Apoptosis Pathways

Background: Chronic myeloid leukemia (CML), is characterized by a reciprocal translocation t(9;22) and forms the BCR/ABL1 fusion gene, which is called the Philadelphia chromosome. The therapeutic targets for CML patients which are mediated with BCR/ABL1 oncogenic are tyrosine kinase inhibitors such as imatinib, dasatinib, and nilotinib. The latter two of which have been approved for the treatment of imatinib-resistant or intolerance CML patients. Mitotic catastrophe (MC) is one of the non-apoptotic mechanisms which frequently initiated in types of cancer cells in response to anti-cancer therapies; pharmacological inhibitors of G2 checkpoint members or genetic suppression of PLK1, PLK2, ATR, ATM, CHK1, and CHK2 can trigger DNA-damage-stimulated mitotic catastrophe. PLK1, AURKA/B anomalously expressed in CML cells, that phosphorylation and activation of PLK1 occur by AURKB at centromeres and kinetochores. Objective: The purpose of this study was to investigate the effect of dasatinib on the expression of genes in MC and apoptosis pathways in K562 cells. Methods: Total RNA was isolated from K-562 cells treated with the IC50 value of dasatinib and untreated cells as a control group. The expression of MC and apoptosis-related genes were analyzed by the qRT-PCR system. Results: The array-data demonstrated that dasatinib-treated K562 cells significantly caused the decrease of several genes (AURKA, AURKB, PLK, CHEK1, MYC, XPC, BCL2, and XRCC2). Conclusion: The evidence supply a basis to support clinical researches for the suppression of oncogenes such as PLKs with AURKs in the treatment of types of cancer especially chronic myeloid leukemia.

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