Table of Content Volume 14 Issue 2 - May 2020

Fatima Bhopalwala Ali¹, Mustafa Ali^2*

 

¹Assistant Professor, Department of Anatomy} {²Assistant Professor, Department of Pathology} Government Medical College, Ratlam, Madhya Pradesh, INDIA.

Email: dr.mustafa-ali@live.com

It is an analytical cytogenetic study of 52 cases of CML where karyotyping was done on bone marrow samples and peripheral blood samples. The marrow aspirate and blood specimens were incubated in RPMI 1640 culture media for 72 hours. Colcemid solution was added and centrifugation was done. The sample was again incubated for ½ hour after adding hypotonic saline solution. Cell button obtained was suspended in methanol + acetic acid suspension. Slides were prepared and treated with trypsin. Finally, Giemsa stained slides were microscopically assessed and karyotyping was done by cytovision software and also by manual method. The hematological analysis involving complete blood count –i.e; haemoglobin estimation, total and differential leukocyte counts and platelet count was done simultaneously for all the cases.

 

Table 1: Phase wise incidence of Disease and t(9;22) positivity

 

Table 2: Phase wise association of additional aberrations

 

Table 3: Association of hematological parameters with phases of CML

 

DISCUSSION

Chronic myeloid leukemia is very common malignancy of blood cells involving myeloid lineage. We observed that most of the patients were in chronic phase of CML (82.69%) followed by accelerated phase (9.62%) and blastic phase (7.69%). Almost all the studies done previously showed similar results.^3,4 40 out of 43 cases in chronic phase showed positivity for t(9;22) (i.e, 93%) while all the cases in accelerated and blastic phase had t(9;22) (100%). While additional chromosomal abnormality was present in 3 out of 43 cases of chronic phase CML (6.97%) 2 out of 5 (40%) and 2 out of 4 (50%) in cases of accelerated and blastic phase of CML respectively. Statistically, association between phase and presence of additional aberrations was significant (p=0.010). Additional chromosomal abnormalities in Ph+ve cells may appear in approximately 5% of patients with newly diagnosed CML in chronic phase, according to several studies.^5,6 Other studies also found higher frequencies of additional chromosomal abnormalities as the CML progressed to accelerated and blastic phase similar to present study. ^{7, 8} Most of the hematological parameters were in accordance with phases of CML. Blast cell counts (4.69±5.61, 11±2.28, 30±4.74) and total leukocyte counts (80251±64672, 126434±73358, 131250±78292) increased from chronic to blastic phase. Hemoglobin count reflected anemic picture in all the phases and was lowest in blastic phase. Basophils count showed increased values in accelerated and blastic phase compared to chronic phase. Thrombocytosis was present in all the three phases with highest values in blastic phase. These findings were similar to other studies done previously. ^{9, 10}

 

CONCLUSION

The cytogenetic and hematological markers of CML are important tools used for diagnosis, clinical staging, prognosis and treatment management of the disease. As such complete laboratory workup including hematological and cytogenetic evaluation of each CML patient becomes mandatory at the time initial diagnosis as well as during treatment and follow up.

 

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