Affiliation:
1. Department of Biochemistry and Microbiology, Faculty of Pharmacy, Damascus University, Damascus, Syria
2. Clinical Laboratories Department, Al-Assad Hospital, Damascus University, P.O. Box 10769, Damascus, Syria
Abstract
Background. In Syria, CML patients are started on tyrosine kinase inhibitors (TKIs) and monitored until complete molecular response is achieved.BCR-ABLmRNA transcript type is not routinely identified, contrary to the recommendations. In this study we aimed to identify the frequency of differentBCR-ABLtranscripts in Syrian CML patients and highlight their significance on monitoring and treatment protocols.Methods. CML patients positive forBCR-ABLtranscripts by quantitative RT-PCR were enrolled.BCR-ABLtranscript types were investigated using a home-made PCR method that was adapted from published protocols and optimized. The transcript types were then confirmed using a commercially available research kit.Results. Twenty-four transcripts were found in 21 patients. The most common was b2a2, followed by b3a2, b3a3, and e1a3 present solely in 12 (57.1%), 3 (14.3%), 2 (9.5%), and 1 (4.8%), respectively. Three samples (14.3%) contained dual transcripts. While b3a2 transcript was apparently associated with warning molecular response to imatinib treatment, b2a2, b3a3, and e1a3 transcripts collectively proved otherwise (P=0.047).Conclusion. It might be advisable to identify theBCR-ABLtranscript type in CML patients at diagnosis, using an empirically verified method, in order to link the detected transcript with the clinical findings, possible resistance to treatment, and appropriate monitoring methods.