Lavaut SK, Quintero SY, Hernández AN

Language: Spanish
References: 18
Page: 1-8
PDF size: 324.62 Kb.

ABSTRACT

The Philadelphia chromosome (Ph) is present in more than 90% of patients with chronic myeloid leukemia. An extra Ph chromosome is one of the secondary alterations commonly observed in clonal evolution and it could be as na additional derivative or anisochromosome of the derivative. It is na alteration acquired during the progression of the disease with prognostic implications. We present two cases with a diagnosis of chronic myeloid leukemia, Who showed resistance to treatment with imatinib mesylate. In both patients,the chromosomal study with G-band technique, show cell lines with two isochromosomes from the derivative of 22, 2ider(22)t(9; 22). The first case died in blast crisis and to the second after not responding to the first line treatment, was precribed nilotinib but the evolution was unsatisfactory. Secondary chromosomal alterations are associated with a negative impact on survival and the progression to accelerated phase and blast crisis of the disease.

REFERENCES

1. Li Q, Lin XJ, Chen H, Gong J, Li Z, Chen ZN. Co-existence of isodicentric Ph chromosomes and the three-way Ph chromosome variant t(3;9;22)(p21;q34;q11) in a rare case of chronic myeloid leukemia.Oncol Lett. 2018;15(4):4599-4603. DOI: 10.3892/ol.2018.7866. [ Links ]

2. Loo E, Bansal P, Cherukuri D, Arana C. Isodicentric Philadelphia chromosome: an uncommonchromosomal abnormality in the chronic phase ofchronic myeloid leukemia (CML).Clin Case Rep.2015;4(1):43-5.DOI: 10.1002/ccr3.444 [ Links ]

3. Borjas-Gutierrez C, Gonzalez-Garcia JR.Philadelphia chromosome duplication as a ring-shaped chromosome. Mol Cytogenet. 2016;21(9):83.DOI 10.1186/s13039-016-0292-2 [ Links ]

4. Vundinti BR, Kerketta L, Korgaonkar S, Vaidya S, Ghosh K. Isodicentric Philadelphia [idic(Ph)]chromosome in a case of CML atchronic phase. Indian J Cancer. 2014;51(3):383-4. [ Links ]

5. Ramachandran KC, Narayanan G, Nair SG, Thambi SM, Kamala LH, Gopinath P, et al. Isodicentric Philadelphia Chromosome: A Rare Chromosomal Aberration in Imatinib-Resistant Chronic Myelogenous Leukemia Patients - Case. Report with Review of the Literature. Cytogenet Genome Res.2016;150(3-4):273-280. DOI: 10.1159/000458164 [ Links ]

6. Shaffer LG, McGowan-Jordan J, Schmid M, International Standing Committee on Human Cytogenetic Nomenclature. ISCN 2013: an international system for human cytogenetic nomenclature (2013). Basel: Karger; 2013. [ Links ]

7. Hernández N, Lavaut K, Ruiz V. Patrones de hibridación del gen de fusión bcr-abl en pacientes cubanos con leucemia. Rev Cubana Hematol Inmunol Hemoter [Internet]. 2016 [citado 2018 Nov 19];32(2):[aprox. 0 p.]. Disponible en:http://www.revhematologia.sld.cu/index.php/hih/article/view/395 [ Links ]

8. Chen Z, Shao C, Wang W, Zuo Z, Mou X, Hu SJ, et al.Cytogenetic landscape and impact in blast phase of chronic myeloid leukemia in the era of tyrosine kinase inhibitor therapy. Leukemia 2017;31(3):585-92.DOI: 10.1038/leu.2016.231. [ Links ]

9. Marzocchi G, Castagnetti F, Luatti S, Baldazzi C, Stacchini M, Gugliotta G, et al. Variant Philadelphia translocations: molecular- cytogenetic characterization and prognostic influence on frontline imatinib therapy, a GIMEMA Working Party on CML analysis. Blood. 2011;117(25):6793-800.DOI: 10.1182/blood-2011-01-328294. [ Links ]

10. Crisan AM, Coriu D, Arion C, Colita A, Jardan C. The impact of additional cytogenetic abnormalities at diagnosis and during therapy with tyrosine kinase inhibitors in Chronic Myeloid Leukaemia. J Med Life. 2015;8(4):502-8. [ Links ]

11. Whang-Peng J, Knutsen TA, Lee EC. DicentricPh1 chromosome. J Natl Cancer Inst.1973;51:2009-12. [ Links ]

12. Al-Achkar W, Wafa A, Moassass F, Klein E, LiehrT. Multiple copies of BCR-ABL fusion gene ontwo isodicentric Philadelphia chromosomesin an imatinibmesylate-resistant chronic myeloidleukemia patient. Oncol Lett.2013;5(5):1579-82. [ Links ]

13. Brahmbhatt MM, Trivedi PJ, Patel DM, ShuklaSN, Patel PS: Multiple copies of BCR/ABL fusionsignals and t(3; 21) in a chronic myeloidleukemia: patient with blast crisis - a rareevent with imatinibmesylate (Gleevec)-resistancein an Indian patient. J Assoc Genet Technol.2014;40(1):4-9. [ Links ]

14. Li Ming Chua C, Tan YY, Chua SP, Ma HB, Koay E, et al: Multiple copies of a rare rearrangementof Philadelphia chromosome in achronic myeloid leukemia patient: a case report. Cancer Genet Cytogenet. 2010;199(1):66-8. DOI:10.1016/j.cancergencyto.2010.01.012. [ Links ]

15. Yamamoto K, Nagata K, Morita Y, Inagaki K, Hamaguchi H. Isodicentric Philadelphia chromosome in acute lymphoblastic leukemia with der(7; 12)(q10;q10). Leuk Res. 2007;31(5):713-8. [ Links ]

16. Loglisci G, Breccia M, Nanni M, Mancini M, De cuia R, Cannella L, et al. Isodicentric duplication of Philadelphia chromosome as a mechanism ofresistance to dasatinib in a patient with chronic myeloid leukemia afterresistance to imatinib. Leuk Lymphoma. 2011;52(7):1372-5. DOI: 10.3109/10428194.2011.565394. [ Links ]

17. Fabarius A, Leitner A, Hochhaus A, Muller MC, Hanfstein B, Haferlach C, et al.Impact of additional cytogenetic aberrations at diagnosis on prognosis of CML: long-term observation of 1151 patients from the randomized CML Study IV. Blood.2011;118(26):6760-8. DOI: 10.1182/blood-2011-08-373902. [ Links ]

18. Greulich-Bode KM, Heinze B. On the Power of Additional and Complex Chromosomal Aberrations inCML. Curr Genomics.2012;13(6):471-6. DOI: 10.2174/138920212802510466. [ Links ]