Immunophenotype of Chronic Myeloid Leukemia Patients on Tyrosine Kinase Inhibitor Treatment at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
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Date
2023-01
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Addis Ababa University
Abstract
Background: Background: Chronic myeloid leukemia (CML) is a cancer affecting blood-forming cells in the bone marrow and blood. It is linked with an abnormal chromosome referredto as Philadelphia (Ph) chromosome, which occurs due to chromosomal translocation t (9; 22).
Objective: The study aimed to assess the immunophenotype of CML patients in chronic oraccelerated phase during treatment with Tyrosine Kinase Inhibitor (TKI) drugs at TikurAnbessaSpecialized Hospital.
Methods: A total of 38 chronic myeloid leukemia patients on TKI treatment and 15 healthycontrol (HC) subjects were enrolled. Peripheral blood samples were collected, and whole bloodwas stained with monoclonal antibodies. A number of cell surface markers were evaluated onboth CD45dimCD34+ leukemic stem cells and normal lymphocytes. Differences in the frequencyof cell subsets between leukemia patients and controls were analyzed using the non-parametricKruskal-Wallis test. Data were summarized as median (interquartile range), and a P-value of lessthan 0.05 was taken as a statistically significant difference.
Result: The percentage of CD45dim cells was significantly higher in CML patients than HCs(p=0.0001). Among CD45dim cells the percentage of CD34+ CD38+ and CD34+ CD38- cellamong CML patients was substantially elevated as compared to the healthy controls (p=0.0006and p=0.0008 respectively). Normal CD19+ B cells were significantly reduced (p = 0.0014), andCD56+ NK and NKT cells were significantly elevated (p = 0.02 and p = 0.0001, respectively) inCML patients relative to controls. CD38 but not CD25 or CD27 was significantly associated withABL-BCR genotype b2a2; however, none of three markers was associated with levels of theABL-BCR transcript levels.
Conclusion: According to the study, we observed significant associations with leukemic stem cell markers, and progression of CML from the chronic to imatinib resistant. Moreover, CML patientshad an altered distribution of normal B, NK and NKT cells relative to healthy controls. Theseesults suggest that flow cytometric characterization of CML patients may have prognostic valuein predicting disease progression, and potentially alerting clinicians that blast crisis may beimminent.
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Immunophenotype CMLFlowcytometryTKI