title: Genetic evaluation of childhood acute lymphoblastic leukemia in Iraq using FTA cards.
abstract: BACKGROUND
  Genetic examination of childhood leukemia has not been available in Iraq. We here report the frequency of TEL-AML1, E2A-PBX1, MLL-AF4, and BCR-ABL chimeric transcripts in 264 Iraqi children newly diagnosed with acute lymphoblastic leukemia (ALL), using FTA cards impregnated with bone marrow aspirate or whole blood.
  
  
  METHODS
  The diagnosis of ALL was made according to standard French-American-British morphologic criteria. Based on the results of storage temperature and duration, most of the FTA samples were preserved at 4°C for up to 6 weeks in five Iraqi hospitals and then transferred to Japan for molecular analysis. Nested reverse transcription-polymerase chain reaction was adopted for the analysis.
  
  
  RESULTS
  TEL-AML1 chimeric transcript product was found in 32 (12.1%) of 264 ALL patients. Eleven (4.2%) patients, 4 (1.5%) patients, and 11 (4.2%) patients had E2A-PBX1 mRNA, MLL-AF4 mRNA, and BCR-ABL mRNA, respectively. One patient had both TEL-AML1 and E2A-PBX1 fusion genes. The incidence of TEL-AML1 in Iraqi ALL children appears to be similar to or slightly higher than those of Jordan (12%) and Kuwait (7%). The prevalence and clinical findings of ALL patients with either E2A-PBX1 or BCR-ABL were comparable to the data reported elsewhere.
  
  
  CONCLUSIONS
  International collaboration via FTA cards may be helpful to improve diagnosis and management of patients with hematological malignancies in low-income and underdeveloped countries.
authors.affiliation: Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Lika'a Fasih Y
authors.initials: LF
authors.lastname: Al-Kzayer
authors.forename: Kazuo
authors.initials: K
authors.lastname: Sakashita
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Matsuda
authors.forename: Salma Abbas
authors.initials: SA
authors.lastname: Al-Hadad
authors.forename: Mazin Faisal
authors.initials: MF
authors.lastname: Al-Jadiry
authors.forename: Wisam Majeed
authors.initials: WM
authors.lastname: Abed
authors.forename: Jaafar M H
authors.initials: JM
authors.lastname: Abdulkadhim
authors.forename: Tariq Abadi
authors.initials: TA
authors.lastname: Al-Shujairi
authors.forename: Janan Ghalib
authors.initials: JG
authors.lastname: Hasan
authors.forename: Hussam M Salih
authors.initials: HM
authors.lastname: Al-Abdullah
authors.forename: Mouroge H
authors.initials: MH
authors.lastname: Al-Ani
authors.forename: Paiman Ali I
authors.initials: PA
authors.lastname: Saber
authors.forename: Toshi
authors.initials: T
authors.lastname: Inoshita
authors.forename: Minoru
authors.initials: M
authors.lastname: Kamata
authors.forename: Kenichi
authors.initials: K
authors.lastname: Koike
mesh_terms: D002648:Child; D002675:Child, Preschool; D050676:Core Binding Factor Alpha 2 Subunit / Q000032:analysis; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000032:analysis; D018398:Homeodomain Proteins / Q000032:analysis; D006801:Humans; D007223:Infant; D007493:Iraq; D008297:Male; D051788:Myeloid-Lymphoid Leukemia Protein / Q000032:analysis; D015514:Oncogene Proteins, Fusion / Q000032:analysis; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000235:genetics*; D012333:RNA, Messenger; D014178:Translocation, Genetic; D000097764:ETS Translocation Variant 6 Protein
chemical_list: D050676:Core Binding Factor Alpha 2 Subunit; D016044:Fusion Proteins, bcr-abl; D018398:Homeodomain Proteins; D051788:Myeloid-Lymphoid Leukemia Protein; D015514:Oncogene Proteins, Fusion; D012333:RNA, Messenger; C113855:MLL-AF4 fusion protein, human; C102421:TEL-AML1 fusion protein; D000097764:ETS Translocation Variant 6 Protein; C089847:E2A-Pbx1 fusion protein