Clinical observation of chromosomal abnormalities in Ph negative cells of chronic myeloid leukemia patients treated with tyrosine kinase inhibitors
10.3760/cma.j.issn.0253-2727.2016.05.011
- VernacularTitle:慢性髓性白血病酪氨酸激酶抑制剂治疗后出现Ph-细胞染色体异常八例临床观察
- Author:
Juan WANG
1
;
Yanli ZHANG
;
Jian ZHOU
;
Yingling ZU
;
Zhen LI
;
Yongping SONG
Author Information
1. 450008,郑州大学附属肿瘤医院血液科
- Keywords:
Leukemia,myelogenous,chronic,BCR-ABL positive;
Tyrosine kinase inhibitor;
Chromosome aberrations;
Philadelphia negative cells
- From:
Chinese Journal of Hematology
2016;37(5):412-416
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the clinical features,characteristics and outcomes of chromosomal abnormalities in Philadelphia negative cells (Ph-CA) of chronic myeloid leukemia (CML) patients treated with tyrosine kinase inhibitor (TKI),and provide the evidence for clinical treatment.Methods We collected and analyzed the clinical and laboratory data of 8 CML patients treated in the affiliated Tumor Hospital of Zhengzhou University from September 2011 to July 2015 and Ph-CA occurred after TKI therapy.Karyotypes and BCR-ABL fusion genes were analyzed by R-banding and real-time quantitative polymerase chain reaction (RT-PCR),respectively.Results 6 cases were male and 2 cases were female,with a median age of 51 (31-75) years old.6 patients had low Sokal risk scores and 2 had intermediate scores.4 cases of Ph-CA occurred with imatinib,1 case with dasatinib and 3 cases with nilotinib.The median duration of Ph-CA appearance was 12.0 (1.7-34.5)months since taking TKI.Chromosomal abnormality +8 was the most common type in Ph-CA,which accounted for 50.0％,followed by-7 (25.0％).When found Ph CA,all patients had complete hematologic response (CHR),but none got main molecular response (MMR).The Ph-CA had gone in 7 cases at the end of follow-up and the median duration was 6.2 (2.5-31.5) months.After Ph-CA disappeared,1 patient obtained MMR and 2 cases achieved complete molecular response (CMR),but Ph+ clone recurred in 1 case.Conclusion Ph CA can be found in CML patients treated with imatinib,dasatinib and nilotinib,and +8 is the most common Ph-CA.So detection of karyotype is significant during treatment.Although most Ph CA can disappear,-7/7q-or other complex karyotypes should be monitored closely.
