PROGNOSTIC SIGNIFICANCE OF BCR/ABL REARRANGEMENTS BY INTERPHASE
POSTER 2
FLUORESCENCE IN SITU HYBRIDIZATION (FISH) IN CML AND ALL
Zeeshan Ahemd
Aga Khan University Hospital, Karachi, Pakistan
Objective
To compare the signal patterns of dual color dual fusion BCR/ABL probe (D-FISH) in the
fluorescence in situ hybridization (FISH) detection for CML and ALL, and to explore their
diagnostic and prognostic value
Introduction:
BCR/ABL fusion gene usually as a result of Philadelphia(Ph) translocation between
chromosomes 9 and 22 in Chronic Myeloid leukemia (CML) as well as Acute Leukemia(ALL).
This rearrangement results in the formation a chimeric BCR/ABL fusion gene on the derivative
chromosome 22. Fluorescence in-situ hybridization (FISH) analysis using dual color BCR/ABL
translocation probes allows the visualization of BCR/ABL rearrangements in both interphase
and metaphase cell, and the presence of the BCR/ABL fusion gene on chromosomes 22 have
been reported in substantial subset of these patients.
Method:
The incidence of both classical and variable BCR/ABL gene rearrangement was determined in
860 patients suspected of CML and ALL using dual fusion fluorescence in situ hybridization
(DF-IFSH) probes
Result:
This study investigated 860 patients of CML and ALL enrolled between January 2016 and
September 2016 at the Aga Khan University Hospital .Out of 860 patients 775(90%) were
diagnosed as CML and 85 cases (10%) were diagnosed ALL. About 659 cases (76%) of both
CML and ALL patients displayed the classical DF-FISH signal pattern and 201(24%) of CML and
ALL shown variable DF-FISH signal pattern. In variable DF-FISH signal various different pattern
were analyzed. In these variable patterns 1F1G1R is 31%, 1F2G1R is 27%, 1F2G2R is 26% and
1F1G2R is 14% were observed in both CML (22%) and ALL (2%). There is also are rare
combination of classical and variable which is around 2 % seen in CML.
Conclusion:
The classical pattern were typically seen in CML but also reported in ALL. The variable pattern
there is equal proportion of 1F1G1R, 1F2G1R, and 1F2G2R but in comparable 1F1G2R is less.
Patients having genetic alteration with loss of 9q and 22 q sequences may be associated with
poor prognosis and the time to disease progression Glivec treatment shorter. Hence
establishment of signal pattern with FISH is important as atypical patterns may have clinical
diagnostic and prognostic implications
SCIENTIFIC PROGRAMME
SESSION I
OPTIMIZING
CYTOREDUCTION
SESSION II
MANAGEMENT OF CML
WITH TKI
SESSION III
MPN RISK
STRATIFICATION
INCLUDING VASCULAR
EVENTS
DEBATE 1
INTERFERON ALPHA
SHOULD BE FRONT LINE
THERAPY IN ALL ET/PV
PATIENTS
ROUNDTABLE 1
INFECTIONS IN
MYELOPROLIFERATIVE
DISORDERS, INCLUDING
CML
ROUNDTABLE 2
PREGNANCY AND
PARENTING
DEBATE 2
ALLOGENEIC STEM CELL
TRANSPLANTATION
SHOULD BE CONSIDERED
THIRD LINE OPTION IN
CHRONIC PHASE CML
SESSION IV
EVOLVING THERAPIES
IN MYELOFIBROSIS
SESSION V
MANAGEMENT OF
ADVANCED AND UNUSUAL
DISEASE (MPN AND CML)
SESSION VI
TREATMENT FREE
REMISSION IN CML
KEYNOTE LECTURE
SELECTED ABSTRACTS
FOR AN ORAL
PRESENTATION
SELECTED ABSTRACTS
FO R A POSTER
PRESENTATION
DISCLOSURES