Browsing by Author "Hailu Saifu"

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    Evaluation of Multiplex Polymerase Chain Reaction (PCR) as Prognostic Tools for Chronic Myeloid Leukemia (CML) Patients in Resource-Limited Setting at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
    (Addis Abeba University, 2021-09) Hailu Saifu; Kinde Samuel; Tsegaye Aster ; Gebremedhin Amha; Howe Rawleigh ; Hailu Dawit
    Background:-The hallmark diagnostic tool for Chronic myeloid leukemia (CML) is Philadelphiachromosome t (9; 22) (q34; q11)) which gives rise to bcr-abl1 fusion oncogenic protein. QrtPCRof bcr-abl1has been established as a prognostic tool since the introduction of TKI drugs.But, in a resource-limited setting, like Ethiopia, multiplex reverse transcriptase PCR, which isused to be as a screening tool, could be adopted into the clinic as a relative prognostic tool thanrelying on hematological response. Objective: - to evaluate multiplex polymerase chain reaction (PCR) as prognostic tools forchronic myeloid leukemia (CML) patients in resource-limited settings at Tikur AnbessaSpecialized Hospital (TASH). Method: - Hospital-based Cross-sectional study design was used for a total of 114 confirmedCML patients who were enrolled at the Hematology Clinic of TASH. Multiplex reversetranscriptase-polymerase chain reaction (RT-PCR) and quantitative reverse transcriptase PCRwere performed at AHRI molecular lab, and Leipzig hematology clinic, respectively. Thedescriptive statistic and ROC curve using excel were used to assess the demographic feature ofthe patients and to evaluate the prognostic value, respectively, and thereby the most valuable cutoff multiplexPCRwascalculatedin comparisonwith QRT-PCR. Result:- of the total enrolled study subjects (114), most of the transcripts were major fusiongene (M-bcr-abl1), b2a2 (28.1%), b3a2 (49.1%), and co-expressed were b2a2/b3a2 (0.9%). Allnew cases and follow-up patients who were positive with the multiplex RT-PCR method for bcrabltranscript were more than 95% agreement with quantitative PCR compared to the limit ofdetection sated for multiplex PCR. Multiplex RT- PCR at a cut-off 0.31% IS and above, incomparison to the standard prognostic tools (Qrt PCR) has a comparable result; sensitivity 96.6%and specificity 88% at the area under the curve 0.977(97.7 %) and CI 95% (0.952 to 1, P-value0.0001). Conclusion: - Follow-up of patients on the hematological parameter is rather crude and notsensitive enough to modify the treatment regimen. But, the use of multiplex PCR, besides asscreening tools, can provide an early sign of relapse as low as 0.31% IS bcr-abl transcript. Ascompared to Qrt-PCR, it is relatively cheap and accessible to be adopted into the routine clinic.