Background: AML is heterogeneous in terms of morphology, immunophenotype, cytogenetics and molecular genetics. Cytogenetic analysis performed at diagnosis is considered to be the most important prognostic factor in AML. The cytogenetic pattern of AML in Bangladeshi population is not clearly known due to lack of large systematic studies. Objectives of the study was to observe the pattern of cytogenetic abnormalities in adult patients with de novo AML, to categorize the patients into three risk groups and to observe the association of cytogenetic findings with FAB subtypes, age, sex & other laboratory findings.
Methodology: This was a cross-sectional study conducted during the period of February’2018 to January’2019 at the Department of Haematology, BSMMU. Total fifty-two newly diagnosed de novo AML patients had been enrolled following inclusion & exclusion criteria. A pre-designed semi-structured data collection sheet was used for data collection. Six cytogenetic abnormalities including t(8;21), t(15;17), inv(16), BCR-ABL1, FLT3-ITD & NPM1 mutations were detected by Real-Time PCR. The association of the cytogenetic findings with the FAB subtypes, age, sex, haemoglobin level, WBC count, platelet count & bone marrow blast percentage were evaluated. Statistical analysis was carried out as required.
Results: In this study, 36 (69.2%) patients showed different cytogenetic abnormalities. The t(15;17) was found to be the most common, detected in 13 (25%) patients. NPM1 mutation was found in 10 (19.23%), t(8;21) in 8 (15.38%) and FLT3-ITD mutation in 8 (15.38%) patients. t(15;17), t(8;21) and inv(16) were found only in M3, M2 and M4 subtypes respectively. FLT3-ITD mutation was common in M4 subtype. Significant association was found with increasing age and cytogenetic risk groups. BCR-ABL1 mutation showed significant relation with increased age. FLT3-ITD mutation showed significant association with increased WBC count and inv16 was significantly associated with relatively less bone marrow blast percentage.
Conclusion: Significant number of patients showed different cytogenetic abnormalities. Therefore, cytogenetic study should be performed routinely in all cases of AML for proper diagnosis, prediction of prognosis and implementation of effective therapeutic measures.
Correspondence: Saqi Md. Abdul Baqi, OSD, DGHS, Mohakhali, Dhaka.