Title: A Case Report of two Chronic Myeloid Leukemia Patients in Chronic Phase Exhibiting IgVH Gene Rearrangement
Author: Asif Iqbal, Arijit Nag, Uttam Kumar Nath, Maitreyee Bhattacharyya
DOI: http://dx.doi.org/10.18535/jmscr/v3i10.13
In CML-CP, 90% of patients present with ph chromosome as sole genetic abnormality in neoplastic cells. Among the additional cytogenetic abnormalities, loss of Y chromosome, trisomy 8, trisomy 19, other single chromosome/gene abnormalities and complex abnormalities with double ACAs were found in that order. Abnormalities involving 14q32 has not been found in literature describing CML-CP, and in limited number of studies have been shown to be exclusively found in lymphoid blast crisis. We are presenting two cases of Chronic myeloid leukemia here, who presented to us with IgVH rearrangement along with ph+ chromosome, and are in chronic phase without any haematological or molecular indication of progressive disease. 1. Sirard, C., Lapidot, T., Vormoor, J., et al, 1996, "Normal and leukemic SCID-repopulating cells (SRC) coexist in the bone marrow and peripheralblood from CML patients in chronic phase, whereas leukemic SRC are detected in blast crisis", Blood,vol. 87, no. 4, pp. 1539-1548. 2. Trotta, R. et al, 2003, "BCR/ABL activates mdm2 mRNA translation via the La antigen", Cancer Cell, vol. 3, no. 2, pp. 145-160. 3. Johansson, B., Fioretos, T., &Mitelman, F. 2002, "Cytogenetic and molecular genetic evolution of chronic myeloid leukemia", ActaHaematol., vol. 107, no. 2, pp. 76-94. 4. Calabretta, B. &Perrotti, D. 2004, "The biology of CML blast crisis", Blood, vol. 103, no. 11, pp. 4010-4022. 5. Bernard, O., Hozumi, N., &Tonegawa, S. 1978, "Sequences of mouse immunoglobulin light chain genes before and after somatic changes", Cell, vol. 15, no. 4, pp. 1133-1144. 6. Jacob, J., Kelsoe, G., Rajewsky, K., & Weiss, U. 1991, "Intraclonal generation of antibody mutants in germinal centres", Nature, vol. 354, no. 6352, pp. 389-392. 7. Seeger, K., Taube, T., Eckert, C., Hanel, C., Pogodda, M., &Henze, G. 2001, "Unusual T-cell receptor delta gene rearrangement patterns revealed by screening of a large series of childhood acute lymphoblastic leukaemia by multiplex polymerase chain reaction", Br.J.Haematol., vol. 113, no. 2, pp.318-322. 8. Nacheva E.P, Brazma D., Virgili A., et al., 2010, “Deletions of immunoglobulin heavy chain and T cell receptor gene regions are uniquely associated with lymphoid blast transformation of chronic myeloid leukemia”, BMC Genomics 2010, 11-41 9. Luatti S, Castagnetti F, Marzocchi G, et al. Additional chromosomal abnormalities in Philadelphia positive clone: adverse prognostic influence on frontline imatinib therapy: a GIMEMA working party on CML analysis. Blood,2012; 120(4): 761-767.Abstract
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