Association of BCR-ABL transcript types and levels with pattern of Ph+ leukemia
| Pattern of disease . | e1a2 (p190) . | e13a2/e14a2 (p210) . | P . |
|---|---|---|---|
| Ph+ ALL at presentation* | 127† | 41‡ | |
| Normalized BCR-ABL transcript level (copies per μg RNA/blast count) | 2313 (37-41 743) | 3751 (224-57 569) | .015 (t test) |
| FCM/qPCR results match on FU | 84/87 (97%) | 15/28 (54%) | <.001 |
| BCR-ABL transcript detectable, 3 months | 49/80 (61%) | 27/30 (90%) | <.005 |
| BCR-ABL transcript detectable, 6 months | 29/64 (45%) | 24/30 (80%) | <.002 |
| Bilineal/biphenotypic Ph+ acute leukemia§ | 4 | 5 | |
| Ph+ AML at presentation | 2‖ | 15¶ | |
| CML at presentation# | 5** | 1645 | |
| Progression to lymphoid blast crisis | 0 | 26 | |
| Progression to myeloid blast crisis | 2 | 69 |
| Pattern of disease . | e1a2 (p190) . | e13a2/e14a2 (p210) . | P . |
|---|---|---|---|
| Ph+ ALL at presentation* | 127† | 41‡ | |
| Normalized BCR-ABL transcript level (copies per μg RNA/blast count) | 2313 (37-41 743) | 3751 (224-57 569) | .015 (t test) |
| FCM/qPCR results match on FU | 84/87 (97%) | 15/28 (54%) | <.001 |
| BCR-ABL transcript detectable, 3 months | 49/80 (61%) | 27/30 (90%) | <.005 |
| BCR-ABL transcript detectable, 6 months | 29/64 (45%) | 24/30 (80%) | <.002 |
| Bilineal/biphenotypic Ph+ acute leukemia§ | 4 | 5 | |
| Ph+ AML at presentation | 2‖ | 15¶ | |
| CML at presentation# | 5** | 1645 | |
| Progression to lymphoid blast crisis | 0 | 26 | |
| Progression to myeloid blast crisis | 2 | 69 |
ALL indicates acute lymphoid leukemia; AML, acute myeloid leukemia; CML, chronic myelogenous leukemia; FCM, flow cytometry; FU, follow-up sample after treatment; and qPCR, BCR-ABL quantitative PCR.
Two cases had cryptic BCR-ABL and are not included in column totals.
Including 24 with one relapse, 20 with 2 or more relapses, 20 with persistent disease not initially responsive to therapy, and 6 who died during or before induction therapy.
Including 9 with one relapse, 9 with 2 or more relapses, 6 with persistent disease not initially responsive to therapy, and 2 who died during or before induction therapy.
Of these, 7 cases were biphenotypic by FCM (5 myeloid/B-cell, 2 myeloid/T-cell phenotype), and 2 cases had apparent bilineal lymphoid and myeloid blasts.
Blasts had monocytic and minimally differentiated phenotype, respectively.
Blasts were minimally differentiated in 2, myeloid in 12, myelomonocytic in 1, and megakaryocytic in 2.
Two cases had cryptic BCR-ABL translocations not detected by PCR assay, 2 had e1a3 fusions, 2 had e19a2/p230, and 3 cases had e14a3 type. Translocations not detected by the quantitative PCR assay are not included in the column totals.
Two cases had an altered transcript with truncation of the e1 exon, identified by DNA sequencing.