Does <i>BCR-ABL</i> transcript type influence the prognosis of patients in chronic myelogenous leukemia chronic phase?

Almeida Filho, T.P. de; Maia Filho, P.A.; Barbosa, Maritza Cavalcante; Dutra, Luana Letícia Alves; Castro, Marilena Facundo de; Duarte, Fernando Barroso; Quixadá, Acy Telles de Souza; Lemes, Romélia Pinheiro Gonçalves

doi:10.1016/j.htct.2018.10.003

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Hematology, Transfusion and Cell Therapy

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Original Articles • Hematol., Transfus. Cell Ther. 41 (2) • Apr-Jun 2019 • https://doi.org/10.1016/j.htct.2018.10.003 copy

Does BCR-ABL transcript type influence the prognosis of patients in chronic myelogenous leukemia chronic phase?

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction and objective:

In this study, we evaluated the influence of the transcript type on hematological and clinical parameters, as well as the event-free survival of 50 patients in the Chronic myeloid leukemia chronic phase.

Methods:

We reviewed the medical records of 55 patients with Chronic myeloid leukemia. The eligibility criteria were based on the availability of hematological and clinical baseline data in the medical records. Data on BCR-ABL transcripts were obtained from medical records.

Results:

Eighteen patients (36%) had the b2a2 transcript, 24 (48%) had b3a2 and 8 (16%) had b2a2/b3a2. The median platelet count for transcripts b2a2, b3a2 and b2a2/b3a2 was 320.65 × 10³/L, 396 × 10³/L, and 327.05 × 10³/L, respectively (p = 0.896). We could not find any differences in relation to the other hematological parameters, when compared to the transcript type. Comparison between spleen and liver size and type of transcript did not differ inside the groups (p = 0.395 and p = 0.647, respectively) and the association between risk scores and transcript type did not show statistical significance (p > 0.05). The 21-month probability for event-free survival was 21%, 48% and 66% for the transcripts b2a2, b3a2 and b2a2/b3a2 respectively (p = 0.226)

Conclusion:

We conclude that the expression BCR-ABL transcripts have no influence on hematological, clinical and event-free survival parameters of patients in the Chronic myeloid leukemia chronic phase.

Abbreviations
CML; M-BCR; EFS; HUWC

Keywords:
Chronic myeloid leukemia; BCR-ABL; Prognosis

Variables	N_T (n_b2a2/n_b3a2/n_b2a2;b3a2)	Mean ± standard deviation or median (range)			p
		b2a2	b3a2	b2a2/b3a2
Age (years)	50 (18/24/8)	46.28 ± 12.86	42.88 ± 15.96	34.75 ± 8.10	0.167
Hemoglobin (g/dL)	48 (17/23/8)	9.94 ± 1.67	10.70 ± 1.35	9.73 ± 1.45	0.167
Leukocytes (10³/L)	49 (18/23/8)	152.5 (30.54–574.4)	153.7 (43–606)	188.385 (30.7–394)	0.741
Basophiles (%)	47 (17/23/7)	2.0 (0–9)	2.0 (0–14)	3 (0–6)	0.937
Eosinophils (%)	46 (17/23/6)	1.0 (0–6)	2.0 (0–15)	2.0 (0–3)	0.492
Myeloblasts (%)	47 (17/23/7)	1.0 (0–8)	2.0 (0–11)	2 (0–13)	0.298
Platelets (10³/L)	49 (18/23/8)	320.65 (179–1568)	396 (166–1165)	327.05 (227–703)	0.886

Variables	Transcripts			p
	b2a2	b3a2	b2a2/b3a2
Spleen and liver size, median; no. (range)
Spleen (cm)	9; 15 (0–30)	6; 20 (0–25)	10; 7 (4.5–15)	0.395^a a Kruskal–Wallis test.
Liver (cm)	3; 15 (0–8)	0; 12 (0–10)	1; 6 (0–4.5)	0.647^a a Kruskal–Wallis test.
Sokal score, no. (%)
Low	4 (28.5)	5 (25)	2 (33)	0.824^b b Chi-square test.
Intermediate	4 (28.5)	7 (35)	3 (50)
High	6 (43)	8 (40)	1 (17)
Hasford score, no. (%)
Low	7 (50)	5 (25)	4 (67)	0.104^b b Chi-square test.
Intermediate	3 (21.5)	12 (60)	2 (33)
High	4 (28.5)	3 (15)	0 (0)
EUTOS score, no. (%)
Low	11 (79)	16 (80)	6 (100)	0.470^b b Chi-square test.
High	3 (21)	4 (20)	0 (0)
ELTS score, no. (%)
Low	6 (43)	11 (55)	3 (50)	0.695^b b Chi-square test.
Intermediate	2 (14)	3 (15)	2 (33)
High	6 (43)	6 (30)	1 (17)

Countries	Source	Type of transcript (%)
		b2a2	b3a2	b2a2/b3a2
Current study	Brazil	36.0	48.0	16.0
13	USA	38.0	52.0	10.0
14	United Kingdom	40.0	55.0	5.00
15	Italy	43.0	57.0	0.00
16	Poland	29.5	62.3	8.20
17	India	27.0	56.5	5.00
18	Brazil	41.0	59.0	0.00
19	Russia	33.3	66.6	0.00
23	Brazil	33.0	55.0	12.0
6	India	39.0	54.0	7.00
20	United Kingdom	41.0	46.0	0.00
7	India	32.0	68.0	0.00
21	Sudan	53.5	41.9	2.30
22	Ecuador	94.6	5.40	0.00
10	USA	42.0	41.0	18.0

Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH) R. Dr. Diogo de Faria, 775 cj 133, 04037-002, São Paulo / SP - Brasil - São Paulo - SP - Brazil
E-mail: htct@abhh.org.br

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[1] *Corresponding author at: Universidade Federal do Ceará (UFC), 1210 Capitão Francisco Pedro St., Rodolfo Teófilo, Fortaleza, CE, Brazil. E-mail address: tarcisio_900@hotmail.com (T. de Almeida Filho).