International Reporting Scale of &lt;i&gt;BCR-ABL1&lt;/i&gt; Fusion Transcript in Chronic Myeloid Leukemia: First Report from India

Balasubramanian, Poonkuzhali; Chendamarai, Ezhilarasi; Markose, Preetha; Fletcher, Linda M.; Branford, Susan; George, Biju; Chandy, Mammen; Srivastava, Alok

doi:10.1159/000334716

Cited by 8 publications

(10 citation statements)

References 31 publications

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“…34-37 Studies in which there were no data on patients who died or analysis was confined to patients who were followed-up in the outpatient department were also excluded. 38 Of the 37 studies thus reviewed, one was related to epidemiology, 36 one concerned efforts to set up monitoring facilities in India, 7 six reported on the mutation profile in Indian patients receiving imatinib, five reported outcomes in pediatric patients, and 24 discussed outcomes in adult patients (Fig 1). …”

Section: Methodsmentioning

confidence: 99%

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Chronic Myeloid Leukemia in India

Ganesan

Kumar

2017

JGO

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BackgroundIn the last decade, the use of imatinib has brought a paradigm shift in the management of chronic myeloid leukemia (CML). In India, imatinib has been available for more than a decade and has been made accessible to all segments of the population because of patient assistance programs and cheaper generic versions. Despite improvements in survival, there are unique challenges in the Indian context.MethodsWe reviewed published data pertaining to CML in India for the period of 1990 to 2016, using PubMed advanced search with the terms chronic myeloid leukemia and India, and included studies that reported on epidemiology, monitoring for therapy, treatment outcomes, and resistance. Additionally, the references in retrieved articles were also reviewed.ResultsThirty-seven studies were identified. The incidence of CML may be slightly lower in India than in the West, but there was only a single article reporting population-based data. Indian patients presented with more advanced disease. Most centers have access to imatinib as first-line therapy, but there is limited availability of molecular monitoring and second-line therapy. Most of the outcome data were retrospective but seemed comparable with that reported in Western centers. Drug adherence was impaired in at least one third of patients and contributed to poor survival.ConclusionFocused prospective studies and cooperative studies might improve the quality of data available. Future studies should focus on adherence, its effects on outcomes, and methods to address this problem.

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Section: Methodsmentioning

confidence: 99%

“…To counter this, international standardization has been proposed, but there are few laboratories in India that have standardized testing available. 7 …”

Section: Methodsmentioning

confidence: 99%

Chronic Myeloid Leukemia in India

Ganesan

Kumar

2017

JGO

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“…The ratios greater than 1.0 suggest the samples were diagnostic samples whereas ratios less than 1.0 suggest they are follow-up samples. 24,25 This study therefore had 44 diagnostic samples and 6 follow up samples.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of micro RNA 150 marker in BCR-ABL positive chronic myeloid leukaemia patients on imatinib mesylate

Ezeanosike¹,

Afonne

2017

Int J Contemp Pediatr

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Background: Micro-RNAs control gene expression by destabilizing targeted transcripts and inhibiting their translation. In chronic myeloid leukaemia (CML), abnormal expressions of miRNAs have been described. The current treatment for newly diagnosed cases of CML is imatinib mesylate which produces rapid haematological responses. It is currently impossible to predict whether a patient will develop resistance to imatinib mesylate. This makes identification of predictors of resistance to imatinib an important goal in management of patients with CML. MicroRNA expression patterns can be used to predict outcome which can be remission or relapse. This study therefore, was set to assess the possible use of microRNA 150 for prognostication.Methods: Fifty peripheral blood samples previously collected from CML patients who were being treated with imatinib mesylate and stored in the refrigerator at +4°C were analyzed for the expression of microRNAs 150. Total RNA was extracted from guanidium isothiocynate (GITC) lysate of the blood samples using RNeasy mini spin column. The total RNA was converted to complimentary DNA by random hexamer priming using Murine Moloney Leukaemia Virus Reverse Transcriptase. Real time Multiplex PCR was used for detecting Breakpoint Cluster Region-Abelson Murine Leukaemia (BCR-ABL) transcript type.Results: The patients’ samples showed an expression of miRNA-150. Correlation of BCR-ABL ratio with miRNA-150 was done and the Spearman correlation coefficient (Rho) between BCR-ABL1 and miRNA-150 was 0.442 (p = 0.001; CI = 0.18-0.65) showing that there was a positive correlation between BCR-ABL1 and miRNA-150. The coefficient of determination was 20% (CI = 3-42%), which implies that about 20% of BCR-ABL1 ratio could be accounted for by the miRNA-150 values.Conclusions: Therefore, once patients who are on imatinib achieve molecular remission of the CML, the miRNA-150 can be useful in predicting outcome which could be relapse or complete molecular remission but is weak at diagnosis in predicting such outcome.

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“…Non‐IS‐standardized laboratory results can be useful in showing the trend in MR in serially collected samples from the same patient, but may not always reliably indicate whether that patient has reached or missed these key BCR‐ABL1 levels – thus increasing the risk of inappropriate treatment decisions. Adoption of the IS for MR reporting requires either (i) the experimental calculation (and periodical revalidation) of a conversion factor through the exchange of batches of samples between national reference centres and the constellation of local laboratories engaged in CML patient monitoring (Muller et al , ; Balasubramanian et al , ; Yoshida et al , ) or (ii) routine use of one of the commercial kits containing reference materials calibrated on the international standards recently developed by the World Health Organization (White et al , , , ).…”

Section: Current Mr Monitoring Methodologymentioning

confidence: 99%

Present and future of molecular monitoring in chronic myeloid leukaemia

et al. 2016

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Currently, physicians treating chronic myeloid leukaemia (CML) patients can rely on a wide spectrum of therapeutic options: the best use of such options is essential to achieve excellent clinical outcomes and, possibly, treatment-free remission (TFR). To accomplish this, proper integration of expert clinical and laboratory monitoring of CML patients is fundamental. Molecular response (MR) monitoring of patients at defined time points has emerged as an important success factor for optimal disease management and BCR-ABL1 kinase domain mutation screening is useful to guide therapeutic reassessment in patients who do not achieve optimal responses to tyrosine kinase inhibitor therapy. Deeper MRs might be associated with improved long-term survival outcomes. More importantly, they are considered a gateway to TFR. In molecular biology, novel procedures and technologies are continually being developed. More sophisticated molecular tools and automated analytical solutions are emerging as CML treatment endpoints and expectations become more and more ambitious. Here we provide a critical overview of current and novel methodologies, present their strengths and pitfalls and discuss what their present and future role might be.

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International Reporting Scale of <i>BCR-ABL1</i> Fusion Transcript in Chronic Myeloid Leukemia: First Report from India

Cited by 8 publications

References 31 publications

Chronic Myeloid Leukemia in India

Chronic Myeloid Leukemia in India

Prognostic significance of micro RNA 150 marker in BCR-ABL positive chronic myeloid leukaemia patients on imatinib mesylate

Present and future of molecular monitoring in chronic myeloid leukaemia

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