ABSTRACT
Background: The rationale of this study is to reveal the statistics of pediatric chronic myeloid leukemia (CML) patients. Subjects and Methods: It is a retrospective analysis conducted to assess pediatric CML data from January 1998 to December 2014. There are 65 (3.2%) pediatric CML patients out of entire 2008 patients of CML. Data were analyzed regarding epidemiological characteristics, clinical presentations, response and side effects of imatinib, event-free survival, and overall survival of the pediatric CML patients. Results: The median age of diagnosis was 11.84 years, and 76.9% patients were male and 23.07% patients were female. Sixty (92.3%) patients were in CML-chronic phase, 3 (4.6%) patients in CML-accelerated phase, and 2 (3.07%) patients in CML-blastic crisis. Most common initial symptoms and signs are weakness (60.0%), abdominal pain (55.38%), splenomegaly (100%), and hepatomegaly (86.5%). 67.3% of patients have white blood counts <100 × 109/L and 92.3% had platelets >150 × 109/L. In the initial months of 2002, imatinib was available and utilized in 54 patients. Of 54 patients, complete hematological response at 3 months, partial cytogenetic response at 6 months, complete cytogenetic response at 12 months, and major molecular response (MMR) at 18 months were 77.77%, 59.2%, 48.14%, and 40.74%, respectively. MMR at 36 months was 62.96% ( n = 34). Most common imatinib-related side effects are gastrointestinal upset and myelosuppression. Conclusion: Pediatric CML in India is comparable with Western countries regarding epidemiological characteristic, clinical presentations, and tolerance of imatinib. As there is a paucity of universal literature regarding pediatric CML (especially data from Southeast Asian region), this article may fill up that space
ABSTRACT
Introduction:The FMS-like tyrosine kinase-3 (FLT3), a member of the Platelet-derived growth factor (PDGF-R) subfamily of receptor tyrosine kinases, expressed on early hematopoietic progenitor cells play an essential role in survival and differentiation of stem cell. Majority of acute myeloid leukemia (AML) patients have mutation in this gene. Two types of frequent mutations are present in this gene. Both the types FLT3-ITD and D835 mutations play an important role in prognosis of AML patients. Methods:Total 33 patients were enrolled in the study. Blood samples were collected from the subjects, from which the DNA isolation was carried out.For FLT3-ITD mutation, PCR was performed and for D835 mutation PCR-RFLP was performed. DNA segments were amplified using Polymerase Chain Reaction (PCR). Results: FLT-3 ITD mutation was detected in 12% of patients and D835 mutation was detected in 3% of patients. The study revealed significant correlation between ITD and Tdt, while D835 negatively correlated with CD33, HLADR and Tdt. However, there was no substantial correlation of D835 with LDH value. also revealed that FLT-3 ITD significantly correlated with LDH values in AML patients. The mean value of LDH was 753.45 IU/L in ITD positive patients as compared to ITD negative patients with 338 IU/L mean LDH value, suggesting higher LDH values in ITD positive. Conclusion:These Genotypic analysis of FLT-3 mutation results from West Indian population provide important tools for understanding of AML pathogenesis and determination of appropriate therapeutic intervention. Further large number of patient data can also corroborate these significant results.