A decade-long analysis of 98 chronic myeloid leukemia patients: Laboratory data and clinical progress at a single center

BACKGROUND: Chronic Myeloid Leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of the Philadelphia chromosome (BCR-ABL1 fusion gene). CML primarily progresses through chronic, accelerated, and blast phases. While global studies on BCR-ABL1 fusion transcript types and their...

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Main Authors: Nabihah Mohd Shakri, Razan Hayati Zulkeflee, Mohd Nazri Hassan, Sinari Salleh, Nur Aini Shakirah Ahmad Shuyuti, Marini Ramli, Azlan Husin, Abu Dzarr Abdullah
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Iraqi Journal of Hematology
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Online Access:https://journals.lww.com/10.4103/ijh.ijh_89_24
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author Nabihah Mohd Shakri
Razan Hayati Zulkeflee
Mohd Nazri Hassan
Sinari Salleh
Nur Aini Shakirah Ahmad Shuyuti
Marini Ramli
Azlan Husin
Abu Dzarr Abdullah
author_facet Nabihah Mohd Shakri
Razan Hayati Zulkeflee
Mohd Nazri Hassan
Sinari Salleh
Nur Aini Shakirah Ahmad Shuyuti
Marini Ramli
Azlan Husin
Abu Dzarr Abdullah
author_sort Nabihah Mohd Shakri
collection DOAJ
description BACKGROUND: Chronic Myeloid Leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of the Philadelphia chromosome (BCR-ABL1 fusion gene). CML primarily progresses through chronic, accelerated, and blast phases. While global studies on BCR-ABL1 fusion transcript types and their associations with clinical, laboratory, and prognostic profiles exist, such data is scarce in Malaysia. OBJECTIVES: This study aimed to determine the distribution of BCR-ABL1 fusion transcript types and evaluate their associations with demographic, clinical, laboratory, prognostic profiles, and disease outcomes among Malaysian CML patients. PATIENTS, MATERIALS AND METHODS: A total of 98 patients diagnosed with CML were identified at East Coast Hospital, Malaysia. This 12-year cross-sectional study was carried out using data extracted from patients’ medical records. Molecular results for BCR-ABL1 fusion genes were obtained using one-step multiplex reverse transcriptase polymerase chain reaction. RESULTS: Out of the 98 patients, 56% had e14a2, 41% had e13a2 fusion transcripts, while the remaining 2 patients had e14a3 transcripts. Additionally, 1 patient co-expressed both e13a2 and e14a2. Among patients with the major BCR-ABL1 transcript type, those with e14a2 fusion transcripts showed an older median age (P = 0.025), while patients with e13a2 fusion transcripts had significantly higher white blood cell (WBC) counts (P = 0.014). Furthermore, there were significantly more patients with blastic transformation in the e13a2 group (P = 0.038). The median latency period of CML was 12 months. The blast cell lineages consisted of myeloid (68.4%), followed by B-lymphoid (26.3%) and mixed phenotypic (5.3%). The differences in fusion transcript expression might influence certain parameters; for instance, older patients were associated with the e14a2 fusion transcript. Meanwhile, patients exhibiting e13a2 might have a higher WBC count at diagnosis and be more vulnerable to blastic transformation of CML. CONCLUSIONS: This study highlights the predominance of e14a2 fusion transcripts in Malaysian CML patients and its association with older age. The e13a2 transcript was linked to higher tumor burden and a higher rate of blastic transformation, suggesting potential prognostic significance. These findings underscore the importance of baseline molecular profiling for optimizing disease management.
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spelling doaj-art-3d0cb22768374b78bdff84d97bda7cee2025-08-20T03:30:23ZengWolters Kluwer Medknow PublicationsIraqi Journal of Hematology2072-80692543-27022025-01-01141667510.4103/ijh.ijh_89_24A decade-long analysis of 98 chronic myeloid leukemia patients: Laboratory data and clinical progress at a single centerNabihah Mohd ShakriRazan Hayati ZulkefleeMohd Nazri HassanSinari SallehNur Aini Shakirah Ahmad ShuyutiMarini RamliAzlan HusinAbu Dzarr AbdullahBACKGROUND: Chronic Myeloid Leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of the Philadelphia chromosome (BCR-ABL1 fusion gene). CML primarily progresses through chronic, accelerated, and blast phases. While global studies on BCR-ABL1 fusion transcript types and their associations with clinical, laboratory, and prognostic profiles exist, such data is scarce in Malaysia. OBJECTIVES: This study aimed to determine the distribution of BCR-ABL1 fusion transcript types and evaluate their associations with demographic, clinical, laboratory, prognostic profiles, and disease outcomes among Malaysian CML patients. PATIENTS, MATERIALS AND METHODS: A total of 98 patients diagnosed with CML were identified at East Coast Hospital, Malaysia. This 12-year cross-sectional study was carried out using data extracted from patients’ medical records. Molecular results for BCR-ABL1 fusion genes were obtained using one-step multiplex reverse transcriptase polymerase chain reaction. RESULTS: Out of the 98 patients, 56% had e14a2, 41% had e13a2 fusion transcripts, while the remaining 2 patients had e14a3 transcripts. Additionally, 1 patient co-expressed both e13a2 and e14a2. Among patients with the major BCR-ABL1 transcript type, those with e14a2 fusion transcripts showed an older median age (P = 0.025), while patients with e13a2 fusion transcripts had significantly higher white blood cell (WBC) counts (P = 0.014). Furthermore, there were significantly more patients with blastic transformation in the e13a2 group (P = 0.038). The median latency period of CML was 12 months. The blast cell lineages consisted of myeloid (68.4%), followed by B-lymphoid (26.3%) and mixed phenotypic (5.3%). The differences in fusion transcript expression might influence certain parameters; for instance, older patients were associated with the e14a2 fusion transcript. Meanwhile, patients exhibiting e13a2 might have a higher WBC count at diagnosis and be more vulnerable to blastic transformation of CML. CONCLUSIONS: This study highlights the predominance of e14a2 fusion transcripts in Malaysian CML patients and its association with older age. The e13a2 transcript was linked to higher tumor burden and a higher rate of blastic transformation, suggesting potential prognostic significance. These findings underscore the importance of baseline molecular profiling for optimizing disease management.https://journals.lww.com/10.4103/ijh.ijh_89_24bcr-abl1blast transformationchronic myeloid leukemiafusion transcriptmajor breakpoint cluster region
spellingShingle Nabihah Mohd Shakri
Razan Hayati Zulkeflee
Mohd Nazri Hassan
Sinari Salleh
Nur Aini Shakirah Ahmad Shuyuti
Marini Ramli
Azlan Husin
Abu Dzarr Abdullah
A decade-long analysis of 98 chronic myeloid leukemia patients: Laboratory data and clinical progress at a single center
Iraqi Journal of Hematology
bcr-abl1
blast transformation
chronic myeloid leukemia
fusion transcript
major breakpoint cluster region
title A decade-long analysis of 98 chronic myeloid leukemia patients: Laboratory data and clinical progress at a single center
title_full A decade-long analysis of 98 chronic myeloid leukemia patients: Laboratory data and clinical progress at a single center
title_fullStr A decade-long analysis of 98 chronic myeloid leukemia patients: Laboratory data and clinical progress at a single center
title_full_unstemmed A decade-long analysis of 98 chronic myeloid leukemia patients: Laboratory data and clinical progress at a single center
title_short A decade-long analysis of 98 chronic myeloid leukemia patients: Laboratory data and clinical progress at a single center
title_sort decade long analysis of 98 chronic myeloid leukemia patients laboratory data and clinical progress at a single center
topic bcr-abl1
blast transformation
chronic myeloid leukemia
fusion transcript
major breakpoint cluster region
url https://journals.lww.com/10.4103/ijh.ijh_89_24
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