Follow-up of childhood chronic myelogenous leukemia with monitoring the BCR-ABL fusion gene expression in peripheral blood

Vol. 52 No. 3 Suppl., 2011
This supplement was not sponsored by Outside Organizations.

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Adrienne Horvath, Maria Despina Baghiu, Zsuzsanna Pap, Claudia Banescu, Cristina Oana Marginean, Z. Pavai

Chronic myelogenous leukemia (CML) accounts for 15-20% of adult leukemias but is very rare in children (2%). Fewer than 10% of CML patients are younger than 20 years. CML is a myeloproliferative disorder characterized by the presence of the Philadelphia chromosome or the BCR-ABL fusion oncogene. The objective of this paper is to present the monitoring of imatinib therapy in two children with CML by the BCR-ABL fusion gene expression assessment from peripheral blood with quantitative real-time polymerase chain reaction (PCR) method. Patients and Methods: The 18 and six months follow-up of the patients included clinical examination, routine laboratory tests, bone marrow aspirate investigation including cytogenetic tests and the major BCR-ABL fusion gene expression measurement with qRT-PCR method from the peripheral blood. Results: Patient No. 1 diagnosed with chronic phase CML showed excellent adherence to daily 400 mg imatinib treatment and achieved complete hematologic (CHR) and cytogenetic response (CCR) by three months and major molecular response (MMR) by 12 months, with lack of side effects due to imatinib. Patient No. 2 experienced severe hematologic toxicity, which necessitated temporary withdrawal of the drug. Transient non-compliance together with imatinib dose reduction has driven to treatment failure. In this case, mutational analysis is warranted. Conclusions: BCR-ABL fusion gene expression level measurement from peripheral blood with qRT-PCR method is an excellent tool in the follow-up of CML patients.

Corresponding author: Adrienne Horvath, MD, e-mail: adigyer1@yahoo.com

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ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Diana Stanculescu, Cl. Margaritescu, A. Stepan, Anca Oana Mitrut

Aim: The immunohistochemical study of E-cadherin in gastric carcinomas, related to tumor aggressiveness factors (invasive and metastatic potential). Materials and Methods: The studied material was gastric resection specimens taken from of 60 patients with gastric cancer, during 2009. The tissue was processed using standard histopathological technique, which allowed the assessment of the well-known morphological parameters of prognostic value. Later on the specimens has undergone immunohistochemical processing for E-cadherin (NCH-38 clone), to evaluate its expression in relation with these prognostic parameters. Results: E-cadherin was positive in 65% from gastric carcinomas, with highest positivity index for well (80% cases) and moderate (17.64% cases) differentiated intestinal type tumors, while a large number of poorly differentiated tumors (55.55%) were E-cadherin negative. Among diffuse type carcinomas, the majority of advanced stage tumors (50% of serosal invasive tumors and 100% of peritoneal disseminated tumors) and also a high number of tumors with vascular and lymphatic invasion (50% and respective 80% cases) represented the E-cadherin negative category (54.54%). The E-cadherin staining was also negative in 75% of lymph node positive diffuse type carcinomas and in all metastatic tumors. Conclusions: We found that irrespective of histologic type, the E-cadherin expression was reduced to negativity in advanced stages of gastric carcinoma.

Corresponding author: Diana Stanculescu, PhD candidate, e-mail: seddiana@yahoo.com

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