Clinical Significance Analysis Of Chromosomal Karyotype And ABL Kinase Mutation In 194 Patients With CML

Objective: Collected 194 CML patients of clinical data,analysis of CML patients clinical characteristics?chromosome karyotype and BCR-ABL kinase region mutation,To explore the abnormal characteristics of CML chromosome?detection of BCR-ABL kinase domain mutation and its clinical significance.Methods: The hospital confirmed 194 patients with CML in January 2010 to October 2016,collect patients,gender,age,disease staging,history before IM treatment,the use of interferon treatment time before IM treatment,analysis of peripheral blood cells,size of spleen,bone marrow smears,FISH,RQ-PCR detection BCR-ABL gene level,using G-banding techniques in CML,and done karyotype analysis.According to the treatment response to determine whether patients with drug resistance,37 of which were imatinib mesylate resistance patients.Using the nested PCR sequencing method to test the ABL kinase region.The above data were analyzed statistically.Results: Chromosome karyotype analysis showed that 182(93.81 %)Ph chromosomes were positive and 12 cases(6.19 %)of the CML patients were Ph chromosome negative;167(91.76 %)of the Ph chromosome positive patients had typical Ph translocation t(9;22)(q34;q11).37 patients were resistant to the standard reference to Baccarani et al standard,the study of 194 cases of chronic myeloid Leukemia patients,37 cases of imatinib resistance in patients,of which 18 patients with chronic phase,accounting for 48.6 % of patients with drug resistance,AP / BC 19 cases,accounting for 51.35 %.The median time before IM treatment 3.5 years in drug-resistant patients,CMR patients were 0.65 years,with significant difference(p = 0.016).mutations in patients receiving interferon therapy the median time was 2.95 ± 2.2 years longer than the continuous CMR were 1.5 ± 1.97 years,further analysis suggests a lack of statistical differences(p = 0.176).Beginning in 2013,our department under the "China Guidelines for the Diagnosis and Treatment of Chronic Myeloid Leukemia",for warning and treatment failure in patients with BCR-ABL kinase mutation detection.In this study,194 patients with 48 cases accepted the ABL kinase region mutation detection,see Chapter 2 for details.Of 37 imatinib mesylate resistance patients,6 patients had ABL kinase mutations,and the mutation rate was 16.22 %.There were 2 cases of mutations in 18 patients with CP(11 %)and 4 of the 19 patients with AP / BC Mutation(21.1 %).The chi-square test showed no significant difference(p = 0.672).Among them,2 cases mutations occurred in the P-loop region(37.5 %),and the other regions were F317 L,L298V,E459 K and M351 T.Conclusion: Accelerated translocation and / or additional chromosomal abnormalities were more likely to occur in patients with accelerated and blast crisis CML;The longer the duration of IM treatment,the greater the likelihood of drug resistance in patients;ABL kinase site mutation can also occur in patients treated with second-generation TKIs.