ABSTRACT
Chronic myeloid leukemia (CML) is a hemopoietic condition caused by chromosomal translocation t(9;22)(q34;q11) or bcr-abl fusion gene. The predominant variants of bcr-abl oncogene rearrangement are b3a2 and b2a2. The present study evaluated the efficacy of interferon-a therapy of CML patients and molecular prognostic factors. Cytogenetic response and complete hematological remission were more frequent in CML b3a2 treatment with interferon-a. Moreover, after therapy, chronic phase lasted in that group (p = 0.026) much longer. Overall survival in the group was significantly longer, too (p = 0.046).
Subject(s)
Antineoplastic Agents/therapeutic use , Interferon-alpha/therapeutic use , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Biomarkers, Tumor/metabolism , Humans , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics , Survival Analysis , Treatment OutcomeABSTRACT
AIM: To elucidate prognostic value of MDR-1 gene expression in patients with chronic myeloid leukemia (CML). MATERIALS AND METHODS: The MDR-1 gene expression was studied by in situ hybridization in hemopoietic cells of 63 Ph-positive CML patients in different phases of the disease. The survival of the patients and duration of the chronic phase (CP) were evaluated using the Caplan-Meyer method. RESULTS: MDR-1-positive patients had a shorter survival (p < 0.01) and CP (p < 0.05) than negative ones. MDR-1 gene overexpression has no impact either on the survival or duration of AP and BP (p < 0.05). Moreover, the MDR-1 gene overexpression is not dependent either on the previous treatment or other prognostic markers. CONCLUSION: Overexpression of MDR-1 gene is an independent prognostic factor and an additional parameter to Sokal's scores.
Subject(s)
Gene Expression Regulation, Leukemic/genetics , Genes, MDR/genetics , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics , Adolescent , Adult , Aged , DNA Probes , Female , Hematopoietic Stem Cells/cytology , Humans , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality , Male , Middle Aged , Prognosis , Survival AnalysisABSTRACT
AIM: To define optimal time for transplantation of bone marrow (TBM) in children with hematological malignancies. MATERIALS AND METHODS: 20 allogenic TBMs were performed in children with acute myeloblastic leukemia (6 patients, 2 of them in recurrence), acute lymphoblastic leukemia (7 patients, 4 of them in recurrence), chronic myeloid leukemia (CML) in a chronic stage (3 patients), severe aplastic anemia (3 patients), generalized neuroblastoma (1 patient). Pretransplantation preparation included cyclophosphamide and busulphane or cyclophosphamide, busulphane and vepezide. The graft-versus-host reaction (GVHR) was prevented with cyclosporin A plus methotrexate or cyclosporin A plus urbazone. Engrafting was recognized by change of karyotype and blood group. RESULTS: From 13 children with acute leukemia subjected to TBM in a complete remission 4(33%) are alive, 5 died within 100 days after TBM (TBM was made in recurrence in 4 children), 3 patients died of recurrence 12 months after TBM. One patient with CML and one with severe aplastic anemia remain in remission. The main complications and causes of death in early posttransplantation period were hemorrhagic syndrome, infectious complications, GVHR. According to a one-year follow-up, the recurrent disease caused death most frequently. CONCLUSION: Positive result of TBM is related to the disease stage at transplantation.
Subject(s)
Bone Marrow Transplantation , Hematologic Neoplasms/therapy , Adolescent , Bone Marrow Transplantation/adverse effects , Bone Marrow Transplantation/statistics & numerical data , Child , Child, Preschool , Hematologic Neoplasms/complications , Hematologic Neoplasms/mortality , Humans , Transplantation Conditioning , Transplantation, HomologousABSTRACT
The investigation deals with a simplified modification or molecular-genetic detection of translocation t(9;22) using a combination of reverse transcription and polymerase chain reactions (RT-PCR). Unlike the available protocols, analysis is carried out using one enzyme--TET-Z polymerase--(instead of two) which has both revertase and DNA-polymerase activities. The present modification is highly sensitive, less time-consuming and cheaper. The method has proved useful for both diagnosing t(9;22) translocation and diagnosing and monitoring minimal residual disease remaining after marrow transplantation.
