cytogenetic study on leukemic Egyptian children

ABSTRACT

This study included forty newly diagnosed children with acute lymphoblastic leukemia [ALL]. On admission blood samples were taken from each patient for cytogenetic analysis by G-banding and it was successful in 37/40 patients [Gr. A] Normal karyotype was present in 20 cases [54.1%] out of 37.On the other hand numerical and structural aberrations were seen in 13 cases [35.1%] and 3 cases [8.1%] respectively; while both aberrations were detected in only one case [2.7%]. The study of the Giemsa banded chromosomes of the hyperdiploid cases showed that chromosome 21 was mostly added, followed by chromosomes [6,10 and X],chromosomes [4 and 14], number [15,17,and 18], [5 and 8], chromosome 16, and finally chromosomes [9 and 20] in that descending frequency. Hyperdiploid ALL have good prognosis on remission therapy as indicated by their chromosomal analysis. Hypodiploid karyotype was present in four cases of [Gr. A] one male and 3 females who showed poor prognosis and short duration of survival. Tetraploidy was encountered in only two male cases .One case died during his treatment period and other one showed bad prognosis as indicated by his blood analysis after treatment. Translocation t [4;l 1] [q21;q23] was found in one female and one male patients [5.4%]. The female died 3 weeks after diagnosis, while the male patient showed poor prognosis after one month of conventional chemotherapy. Another translocation t [l;19] [q23;p13] was found in 2 male patients [5.4%], they were alive after one month of treatment and they showed good prognosis during the remission induction stage. These findings imply that the accurate identification of chromosomal abnormalities in ALL patients is essential for diagnosis and may be of great value in predicting the prognosis of such cases. After 4 weeks of chemotherapeutic treatment, second blood samples from 32 cases [Gr. B] were cytogenetically normal. The remaining eight cases showed four of them died 2 weeks after diagnosis [one teraploidy male; two hypoploid females; and one translocation [4; 11] female]; one case discontinued [hypodiploid male]; and three cases failed to remission induction [one hyper-diploid female, one tetraploid male, and one translocation [4;11] male]