Morphologic Changes in the Bone Marrow in Patients of Chronic Myeloid Leukemia (CML) Treated with ImatinibMesylate

Srinivas, B.; Paul, Tanusree; Uppin, Shantveer G; Uppin, Megha S; Jacob, Rachel; Digumarti, Raghunadharao

doi:10.1007/s12288-011-0136-5

Cited by 6 publications

(8 citation statements)

References 21 publications

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“…[2] There are very few studies from Indian subcontinent which correlates haematological, cytogenetic and marrow response after Imatinib treatment. [4,5,10] In this study, the marrow changes three months post Imatinib were correlated with HR and CR. Imatinib induces durable hematologic and cytogenetic responses in patients of CML, though the former is achieved earlier.…”

Section: Discussionmentioning

confidence: 86%

“…[2] Yet, marrow response in Imatinib treated CML patients is less well defined than haematological and cytogenetic response (HR and CR) with a paucity of studies from South India. [3,4] Hence our aims were 1) To study the hematologic response in CML patients after 3months of Imatinib. 2) To study the cytogenetic response in CML patients after 6months of Imatinib.…”

Section: Introductionmentioning

confidence: 99%

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Various treatment responses in Imatinib treated CML patients with emphasis on marrow profile: a descriptive study in a tertiary care centre in South India

Mathumithra

Basu

Kar

2018

APALM

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Background: CML is a clonal stem cell neoplasm characterised by reciprocal translocation between chromosomes 9 and 22. Imatinib is used in its treatment which induces hematological, cytogenetic and molecular response. Yet, marrow response is less well defined than hematological and cytogenetic response (HR and CR). Hence our aims were 1. To study the hematologic response in CML patients after 3 months of Imatinib 2. To study the cytogenetic response in CML patients after 6 months of Imatinib.3. To study and categorize morphological changes in marrow at the end of three months of treatment. Materials and Methods:Forty six newly diagnosed patients of CML (BCR-ABL positive), irrespective of phase, were included. HR and CR was evaluated at the end of three months and six months of Imatinib therapy, respectively. A bone marrow aspirate and biopsy were performed at the end of three months, marrow responses were classified and parameters were analysed.Results: Of 46 patients, 91.3% of patients attained complete hematological response.30/46 patients had a follow up FISH analysis at 6 months, of whom 70% attained complete cytogenetic response (table/figure 3). Twenty-nine (64.5%) of the post treatment aspirates were diluted and imprints/biopsy yielded information. Twenty-eight (63%) patients showed marrow normalization, eleven (23%) persistence of disease, four (8%) progression of disease to blast crisis (BC) and three (6.5%) hypo cellular marrow. Conclusion:Post therapy BM in CML, when undertaken should have biopsy rather than an aspirate alone, as aspirates are often diluted and biopsy may yield useful information like impending blast crisis.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Various treatment responses in Imatinib treated CML patients with emphasis on marrow profile: a descriptive study in a tertiary care centre in South India

Mathumithra

Basu

Kar

2018

APALM

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“…Twenty-nine percent normocellularity, 71% hypercellularity, and no hypocellularity were found in resistant CGL patients. There were significant differences (p <0.05) of bone marrow cellularity and the basophils count between remissive and resistant CGL patients, but no significant differences were found in the M:E ratio, myeloblast count, and eosinophil count (p > 0.05) (Table 4) Therefore, further studies were still needed to determine the correlation between bone marrow features, cytogenetic responses, and molecular responses by using bone marrow cellularity as the morphological criteria of bone marrow and basophil counts in bone marrow for additional evaluations of Imatinib therapy before obtaining results from assessment of cytogenetic responses and [24][25][26][27][28][29][30][31] molecularity in CGL patients treated with TKI. Tyrosine kinase inhibitor will bind to the ATP-binding site of the tyrosine kinase protein group including BCR-ABL, there by inhibiting tyrosine kinase activity.…”

Section: Resultsmentioning

confidence: 99%

Differences of Bone Marrow Features and BCR-ABL Variants in Chronic Granulocytic Leukemia Post Tyrosine Kinase Inhibitor Therapy

Devi¹,

Prenggono²,

Ap³

et al. 2020

Indonesian J. Clin. Pathol. Med. Lab.

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Chronic Granulocytic Leukemia (CGL) occurs due to chromosomal translocation (9;22) known as Philadelphia chromosome. p210 BCR-ABL1 oncogenes are classified into b2a2 and b3a2 transcripts which possibly lead to different clinical manifestations and response to therapy. This study was aimed to prove that there is a difference of bone marrow features and BCR-ABL between remissive and resistant CGL after Tyrosine Kinase Inhibitor (TKI) therapy. This research was an observational study with a cross-sectional design carried out at Ulin Hospital Banjarmasin on 32 subjects. BCR ABL was detected by using PCR and bone marrow features were assessed by using bone marrow aspiration technique. The difference of bone marrow features and BCR-ABL variants was analyzed by using T-test (p < 0.005) and Chi-Square (p < 0.005), respectively. There was a difference of BCR-ABL variants with p=0.091 and characterized by M:E ratio (p=0.124), myeloblast count (p=0.063), and eosinophil count (p=0.055). In addition, there was a difference of bone marrow cellularity (p=0.000) and basophil count (p=0.016) between remissive CGL and resistant CGL patients. There was no difference of BCR ABL variants, myeloblast count and eosinophil count between remissive CGL and resistant CGL patients. However, there was different of bone marrow cellularity and basophil count between remissive CGL and resistant CGL patients.

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“…

Dear Sir, We read with interest the article by Srinivas et al [1] describing morphological changes in bone marrows of chronic myeloid leukemia (CML) patients treated with imatinib mesylate (IM). We would like to share our experience with one such case with an unusual marrow finding.

A 60-year-old male, a chronic smoker, was first diagnosed with low-grade transitional cell carcinoma (TCC), urinary bladder in 2003 after he underwent endoscopic transurethral resection of a bladder tumor (TURBT).

…”

mentioning

confidence: 99%

“…Dear Sir, We read with interest the article by Srinivas et al [1] describing morphological changes in bone marrows of chronic myeloid leukemia (CML) patients treated with imatinib mesylate (IM). We would like to share our experience with one such case with an unusual marrow finding.…”

mentioning

confidence: 99%

Gelatinous Marrow Transformation in an Imatinib-Treated CML Patient with Pancytopenia Following Severe Sepsis

Agrawal

Sharma

Narang

et al. 2012

Indian J Hematol Blood Transfus

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Dear Sir, We read with interest the article by Srinivas et al. [1] describing morphological changes in bone marrows of chronic myeloid leukemia (CML) patients treated with imatinib mesylate (IM). We would like to share our experience with one such case with an unusual marrow finding.A 60-year-old male, a chronic smoker, was first diagnosed with low-grade transitional cell carcinoma (TCC), urinary bladder in 2003 after he underwent endoscopic transurethral resection of a bladder tumor (TURBT). He suffered local recurrences in 2004 and 2005, and repeat TURBTs were done followed by administration of intravesical BCG, and subsequently gemcitabine and mitomycin. The third TURBT in 2005 was complicated by bladder perforation requiring lapartomic repair.He remained well till 2008 when routine follow-up hemograms revealed persistent leukocytosis. The spleen, impalpable clinically, was mildly enlarged on ultrasound. Investigations revealed hemoglobin 8.8 gm %, platelets 868 9 10 9 /l and TLC 68.3 9 10 9 /l with 56 % neutrophils, 2 % lymphocytes, 5 % eosinophils, 10 % basophils, 1 % promyelocytes, 13 % myelocytes and 13 % metamyelocytes. Leukocyte alkaline phosphatase score was five (reference range 40-100) and reverse transcriptase PCR for the p210 bcr-abl fusion transcript was positive.

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Morphologic Changes in the Bone Marrow in Patients of Chronic Myeloid Leukemia (CML) Treated with ImatinibMesylate

Cited by 6 publications

References 21 publications

Various treatment responses in Imatinib treated CML patients with emphasis on marrow profile: a descriptive study in a tertiary care centre in South India

Various treatment responses in Imatinib treated CML patients with emphasis on marrow profile: a descriptive study in a tertiary care centre in South India

Differences of Bone Marrow Features and BCR-ABL Variants in Chronic Granulocytic Leukemia Post Tyrosine Kinase Inhibitor Therapy

Gelatinous Marrow Transformation in an Imatinib-Treated CML Patient with Pancytopenia Following Severe Sepsis

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