Complex three-way Philadelphia translocation t(6;9;22) (p23;q34;q11.2) along with unusual t(1;4): A chronic myeloid leukemia case report

Abstract

66according to standard protocol. A total of 20 metaphases analyzed from the bone marrow culture of the patient and karyotyping was performed on the basis of International System for Human Cytogenetic Nomenclature (2016). The FISH analysis was performed according to the standard protocol from sample for confirmation of BCR/ABL gene using dual color fusion FISH probe (Zytovision Probe). All cell's images were captured using Olympus fluorescent microscope BX-61 equipped with a CCD camera and analyzed using Bioview FISH software.Chromosome analysis revealed 46,XX,t (1;4)(p32;p16),t(6;9;22) (p23;q34;q11.2). In the addition of three-way complex translocation t(6;9;22), another unusual translocation t(1;4) (p32;p16) was observed. The FISH was performed to confirm the presence of BCR/ABL fusion gene, which was found to be in all cells. To the best of our knowledge, this is the first report with such a unique translocations in a Ph-positive CML patient involving three chromosomes along with clonal evolution with t(1;4) as a secondary abnormality.Further, clinical follow-up and details of therapeutic response are warranted.