A Novel Four-Way Complex Variant Translocation Involving Chromosome 46,XY,t(4;9;19;22)(q25:q34;p13.3;q11.2) in a Chronic Myeloid Leukemia Patient.
Philadelphia (Ph) chromosome (9;22)(q34;q11) is well established in more than 90% of chronic myeloid leukemia (CML) patients, and the remaining 5-8% of CML patients show variant and complex translocations, with the involvement of third, fourth, or fifth chromosome other than 9;22. However, in very rare cases, the fourth chromosome is involved. Here, we found a novel case of four-way Ph+ chromosome translocation involving 46,XY,t(4;9;19;22)(q25:q34;p13.3;q11.2) with CML in the chronic phase. Complete blood cell count of the CML patient was carried out to obtain total leukocytes count, hemoglobin, and platelets. Fluorescence in situ hybridization technique was used for the identification of BCR-ABL fusion gene, and cytogenetic test for the confirmation of Ph (9;22)(q34;q11) and the mechanism of variant translocation in the bone marrow. The patient is successfully treated with a dose of 400 mg/day imatinib mesylate (Gleevec). We observed a significant decrease in white blood cell count of 11.7 × 10(9)/L after 48-month follow-up. Patient started feeling better generally. There was a reduction in the swelling of the body, fatigue, and anxiety.
Department of Biotechnology, Balochistan University of Information Technology, Engineering and Management Sciences (BUITEMS), Quetta, Pakistan; Office of Research Innovation and Commercialization, Balochistan University of Information Technology, Engineering and Management Sciences (BUITEMS), Quetta, Pakistan.
Muhammad
M
Asif
King Fahd Medical Research Center (KFMRC), King Abdulaziz University , Jeddah , Saudi Arabia.
Mohammad Sarwar
MS
Jamal
Obesity and Diabetes Research Laboratory, Department of Chemistry, University of Azad Jammu and Kashmir , Muzaffarabad , Pakistan.
Abdul Rehman
AR
Khan
Center of Excellence in Genomic Medicine Research (CEGMR), King Abdulaziz University , Jeddah , Saudi Arabia.
Muhammad Imran
MI
Naseer
Department of Biotechnology, Balochistan University of Information Technology, Engineering and Management Sciences (BUITEMS) , Quetta , Pakistan.
Abrar
A
Hussain
Department of Biochemistry, Faculty of Science, Center of Innovation in Personalized Medicine, King Fahd Center for Medical Research, King Abdulaziz University , Jeddah , Saudi Arabia.
Hani
H
Choudhry
Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore , Lahore , Pakistan.
Arif
A
Malik
King Fahd Medical Research Center (KFMRC), King Abdulaziz University , Jeddah , Saudi Arabia.
Shahida Aziz
SA
Khan
King Fahd Medical Research Center (KFMRC), King Abdulaziz University, Jeddah, Saudi Arabia; Department of Molecular Genetics and Enzymology, Division of Human Genetics and Genome Research, National Research Centre, Giza, Egypt (Affiliation ID 60014618).
Maged Mostafa
MM
Mahmoud
King Fahd Medical Research Center (KFMRC), King Abdulaziz University , Jeddah , Saudi Arabia.
Ashraf
A
Ali
Bolan Medical Hospital , Quetta, Balochistan , Pakistan.
Saima
S
Iram
Faculty of Life Sciences, University of Balochistan , Quetta , Pakistan.
Kashif
K
Kamran
Faculty of Life Sciences, University of Balochistan , Quetta , Pakistan.
Asim
A
Iqbal
Department of Medical Genetics, College of Medicine, Umm Al-Qura University , Makkah , Saudi Arabia.
Zainularifeen
Z
Abduljaleel
Center of Excellence in Genomic Medicine Research (CEGMR), King Abdulaziz University , Jeddah , Saudi Arabia.
Peter Natesan
PN
Pushparaj
Center of Excellence in Genomic Medicine Research (CEGMR), King Abdulaziz University , Jeddah , Saudi Arabia.
Mahmood
M
Rasool
BCR–ABL gene; Philadelphia chromosome; chronic myeloid leukemia; complex variant translocation