Background: Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm
characterized by the presence of BCR‐ABL fusion gene (GenBank accession
NC_000022.11). In the vast majority of CML patients, the typical subtype of BCRABL
transcript are b3a2, b2a2 or both. The aim of this study was to determine the
different subtypes of BCR‐ABL transcript and their impact on the demographic and
hematological parameters in Iraqi patients with CML.
Methods: One hundred patients with chronic phase CML (11 newly diagnosed
and 89 imatinib‐resistant) were enrolled in this study. Ribonucleic acid (RNA) was
extracted from leukocytes, and complementary DNA was created using reverse
transcriptase polymerase chain reaction technique. A multiplex polymerase chain
reaction with four specific primers was used to determine the BCR‐ABL fusion subtypes
in each patient.
Results: Male to female ratio was 1.38:1. Fifty‐nine patients expressed b3a2 transcript,
whereas 39 of the remaining cases were positive for b2a2 variant. One case
expressed b2a3 transcript, while the last case coexpressed the two subtypes of mRNA
b3a2/b2a2. Male and female were significantly associated with b3a2 and b2a2 subtypes,
respectively. The b3a2 subtype showed higher total leukocyte count than b2a2
subgroup, while b2a2 variant demonstrated significantly elevated platelet counts
compared to those with b3a2 transcript. A significantly higher plateletcrit percentage
(PCT%) was found in patients with b2a2 transcript whereas.
Conclusions: The testified Iraqi group expressed M‐BCR‐ABL type with preponderance
of b3a2 over b2a2 subtype. There was a gender‐skewed distribution in BCR‐ABL
transcript types with b3a2 transcript more prevalent in males. The type of BCR‐ABL
transcript is reflected by different leukocyte and platelet counts at diagnosis, which
might represent a distinct phenotype and disease biology.
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July 2019
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