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Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

2013, Number 3

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Rev Esp Med Quir 2013; 18 (3)

Cytogenetic Diagnosis and Molecular Following in the Chronic Myeloid Leukemia

Cruz VJ, Arcos FDM, Chávez JMS, Sánchez HMP, Sánchez MDM, Galicia GS, Espinoza ZJR, Cervera CEE

Language: Spanish
References: 29
Page: 253-259
PDF size: 634.46 Kb.


ABSTRACT

In the last decade, therapy for Philadelphia chromosome positive (Ph) has been amended due to global imatinib mesylate (Gleevec™, Glivec™, Novartis, Basel, Switzerland). IM is a potent inhibitor of TK activity (tyrosine kinase) protein-selective chimeric BCR/ABL, preventing their activation and phosphorylation of tyrosine residues involved in the activation of important signaling pathways as apoptosis, proliferation and cell adhesion. The latest report from IRIS (International Randomized Study Imatinib vs interferon alpha) was the first to demonstrate the effectiveness of MI as a first line therapy in patients with Ph positive chronic myeloid leukemia chronic phase; the study indicated that over 90% of patients with MI show improvement and a progression of five years free of disease. Recent studies of patients with MI showed a significant correlation between the percentage of Ph positive metaphases in bone marrow and the levels of BCR/ABL in peripheral blood by quantitative polymerase chain reaction. During therapy, in some patients can be observed additional chromosomal metaphases Ph chromosome positive, which should be monitored during follow-up, however, recognition of these additional changes may also happen in Ph negative metaphases. The clinical significance of these alterations is currently unknown. These findings suggest performing a bone marrow cytogenetic monitoring from 3 to 6 months, in order to obtain a better understanding of the incidence and clinical significance of clonal cytogenetic abnormalities in metaphases Ph-negative/Ph-positive.


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