CORRELATION OF BONE MARROW MORPHOLOGY BEFORE THE START OF THERAPY AND LEVEL OF BCR/ABL TRANSCRIPT IN PATIENTS WITH CHRONIC MYELOIC LEUKEMIA

Autor: Murković, Martina
Přispěvatelé: Hadžisejdić, Ita, Matušan Ilijaš, Koviljka, Babarović, Emina, Mrakovčić-Šutić, Ines
Jazyk: chorvatština
Rok vydání: 2020
Předmět:
Popis: Kronična mijeloična leukemija (KML) je maligna hematološka bolest koju karakterizira recipročna translokacija t(9;22) koja dovodi do stvaranja BCR-ABL1 onkogena. Liječenje KML se provodi tirozin kinaznim inhibitorima (TKI), a veliki molekularni odgovor (engl. Major molecular response, MMR) na terapiju TKI se prati određivanjem razine BCR-ABL1 transkripta u krvi. MMR se definira kada je postignuta ≤0,1% razina BCR-ABL1 transkripta u perifernoj krvi. Cilj ovog istraživanja bio je utvrditi postoji li korelacija morfoloških karakteristika koštane srži, laboratorijskih nalaza periferne krvi, veličine slezene te Sokal indeksa prije početka terapije te postizanja molekularnog odgovora (engl. Molecular response, MR) na terapiju TKI. Analizirana je koštana srž 32 pacijenta s dijagnozom KML u razdoblju od 2004. do 2019. godine. Rezultati su pokazali povezanost postignutog MR s hipercelularnosti koštane srži (p=0,037), odnosno sniženog udjela masnih stanica (p=0,037) te distribucije masnih stanica uz trabekule koštane srži (p=0.010). Također, utvrđena je statistički značajna povezanost između postignutog MR i difuzne distribucije megakariocita (p=0.041), grupacije megakariocita po tipu rahlih klastera (p=0.007) i „cloud-like“ morfologije jezgre megakariocita (p=0.027). Ostali morfološki parametri nisu pokazali statistički značajnu povezanost s MR. Uspoređivanjem karakteristika malih krvnih žila kao što su srednja gustoća (MVD) i srednja površina malih krvnih žila (MVA) nije se našlo povezanosti s MR. Sokal indeks nije pokazao povezanost s MR statusom. Od laboratorijskih nalaza jedino je postotak mijeloblasta (p=0.035) pokazao statistički značajnu povezanost s postignutim MR. Rezultati ove studije ukazuju na mogućnost korištenja morfoloških parametara koštane srži te postotka mijeloblasta periferne krvi kao mogućeg prediktora ishoda terapije u pacijenata oboljelih od KML
Chronic myeloid leukemia (CML) is a malignant hematological disease characterized by the t(9;22) reciprocal translocation which results in the formation of the BCR-ABL1 oncogene. CML treatment with tyrosine kinase inhibitors (TKI) is defined by the major molecular response (MMR) when BCR-ABL1 transcript level is ≤0,1% in the peripheral blood. The aim of this study was to analyze a morphometry of the bone marrow, peripheral blood laboratory results, the spleen size and Sokal score before therapy and compare it to the molecular response (MR) status after the TKI therapy. We analyzed bone marrow biopsy material of 32 patients which were diagnosed with CML in the period between 2004. and 2009. The MR showed statistically significant association with hypercellular bone marrow (p=0,037), lower adipocyte count (p=0,037) and trabecular adipocyte distribution (p=0.010). Also, we found statistically significant association of MR with diffuse distribution of megakaryocytes (p=0.041), loose megakaryocyte clusters (p=0.007) and cloudlike megakaryocyte nuclei (p=0.027). However, there was no statistically significant association between MR status and other morphologic parameters. Blood vessel morphometric characteristics like microvascular density (MVD) and microvascular area (MVD) didn’t show statistically significant association with MR status. Also, Sokal score did not show significant association with MR status. In the peripheral blood, only myeloblast percentage (p=0.035) showed statistically significant association with MR. Our results indicate that some of the bone marrow morphometric parameters as well as peripheral blood myeloblast percentage could serve as predictors to TKI therapy response in CML patients.
Databáze: OpenAIRE
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