title: Efficiency of interphase fluorescence in situ hybridization for BCR/ABL on peripheral blood smears for monitoring of CML patients: a comparison with bone marrow findings.
abstract: Conventional cytogenetic analysis (CCA) is the standard method for monitoring of the Philadelphia (Ph) chromosome in chronic myeloid leukemia (CML). Evaluation of breakpoint cluster region/abelson murine leukemia (BCR/ABL) fusion using interphase fluorescence in situ hybridization on peripheral blood smears (PB-FISH) might be another approach allowing more frequent and less invasive follow-up investigations. Herein, BCR/ABL fusion gene was assessed on 21 PB smears from 16 CML patients in chronic phase. Results of PB-FISH were compared with those of CCA and interphase FISH on bone marrow aspirates (BM-FISH). PB-FISH analysis was combined with CD3 immunophenotyping that allowed simultaneous investigation of the leukemic status of CD3(+) T lymphocytes and scoring CD3(-) cells for BCR/ABL fusion gene. Moreover, the frequency of BCR/ABL fusion in nonlymphoid PB cells was estimated according to the differential leukocyte counts. The incidence of BCR/ABL(+) fusion signals in CD3(+) T cells of CML patients was 5.3% (SD +/- 1.9) and did not exceed the normal cut-off value of 8%. A significant correlation (P < 0.001) was found between results of PB-FISH and methods of BM analysis (CCA or BM-FISH). Correction of PB-FISH results to include only nonlymphoid or CD3(-) cells reduced the mean of differences and improved agreement between PB-FISH and CCA or BM-FISH methods. The best agreement was noted between CCA and PB-FISH on nonlymphoid cells. On the other hand, results of BM-FISH agreed well with those of PB-FISH on CD3(-) cells. These findings imply that PB-FISH on nonlymphoid or CD3(-) cells is reliable and may replace BM analysis for monitoring of response to treatment in CML patients.
authors.affiliation: First Department of Medicine, University of Athens School of Medicine, Athens, Greece. sakel@ncifcrf.gov
authors.forename: S
authors.initials: S
authors.lastname: Akel
authors.forename: A
authors.initials: A
authors.lastname: Kolialexi
authors.forename: A
authors.initials: A
authors.lastname: Mavrou
authors.forename: C
authors.initials: C
authors.lastname: Metaxotou
authors.forename: D
authors.initials: D
authors.lastname: Loukopoulos
authors.forename: X
authors.initials: X
authors.lastname: Yataganas
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D001853:Bone Marrow / Q000473:pathology*; D017252:CD3 Complex / Q000032:analysis; D016044:Fusion Proteins, bcr-abl / Q000097:blood*; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D016130:Immunophenotyping; D017404:In Situ Hybridization, Fluorescence; D016898:Interferon-alpha / Q000627:therapeutic use; D007399:Interphase; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D018655:Lymphocyte Count; D018365:Neoplasm, Residual; D012074:Remission Induction
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D017252:CD3 Complex; D016898:Interferon-alpha; D016044:Fusion Proteins, bcr-abl; D006918:Hydroxyurea