TÜRKİYE’DEKİ KRONİK MİYELOİD LÖSEMİ HASTALARINDA KAN PARAMETRELERİNİN BCR/ABL1 P210 TESTİ ÜZERİNE ETKİLERİ

Amaç: Kronik miyeloid lösemi (KML), BCR/ABL1 füzyon geninden kaynaklanan en yaygın hematolojik malignitelerden biridir. KML'li hastalar genellikle bazofili ve nötrofili içeren lökositoz gösterirler. KML'nin doğrulanması genellikle BCR/ABL1 füzyonunun saptanmasına dayanır. KML şüphesi olan hastalarda BCR/ABL1 p210 testi için periferik kan (PK) diferansiyeli ve tam kan sayımının (TKS) etkisini araştırmayı amaçlıyoruz. Metot: BCR/ABL1 p210 füzyonu için ilk kez test edilen hastaların retrospektif bir değerlendirmesini yaptık. Kliniğimiz veri tabanından 235 hastanın klinik ve laboratuvar bulgularını elde ettik. BCR/ABL1 p210 füzyonu, kantitatif Gerçek Zamanlı Polimeraz Zincir Reaksiyonu (RT-qPCR) ile tespit edilmiştir. Sürekli verilerin karşılaştırılması için t-testi veya Mann-Whitney U testleri uyguladık. Her parametre için alıcı çalışma karakteristiğini (ROC eğrileri) çizdik ve ROC eğrisi altındaki alanı (AUC) hesapladık. Bulgular: 235 hastanın 25'ine (%10.6) yeni KML tanısı kondu. KML hastalarında, diferansiyel ile önemli ölçüde artmış beyaz kan hücresi sayısı (WBC) vardı. Mutlak bazofil sayısı, 0,3 × 103/uL'lik bir kesme değerine sahip olan 0,829'luk ROC eğrisi (AUC) değerinin altındaki en yüksek alanı gösterdi. KML vakalarının %76,00'ında mutlak bazofil sayısı ≥0,3 × 103/uL iken, KML olmayan vakaların %95,24'ünde mutlak bazofil sayısı <0,3 × 103/uL idi. Sonuç: Sonuçlarımız, ≥0,3 × 103/uL mutlak bazofil sayısının BCR/ABL1 p210 test istemini iyileştirmeye ve sağlık hizmeti maliyetlerini düşürmeye yardımcı olabileceğini göstermektedir.

Anahtar Kelimeler:

KML, BCR/ABL1 füzyonu, RT-qPCR, TKS

IMPACT OF BLOOD PARAMETERS ON BCR/ABL1 P210 TESTING IN PATIENTS WITH CHRONIC MYELOID LEUKEMIA IN TURKIYE

Objective: Chronic myeloid leukemia (CML) is one of the most common hematological malignancies derived from the BCR/ABL1 fusion gene. Patients with CML generally manifest leukocytosis with basophilia and neutrophilia. The verification of CML is often based on the detection of BCR/ABL1 fusion. We aimed to investigate the impact of peripheral blood (PB) differential and complete blood count (CBC) on BCR/ABL1 p210 test ordering in patients with suspected CML. Methods: We performed a retrospective assessment of patients tested for the first time for BCR/ABL1 p210 fusion. We obtained clinical and laboratory findings of 235 patients from the database of our clinic. BCR/ABL1 p210 fusion was detected by quantitative real-time polymerase chain reaction (RT-qPCR). We implemented t-tests or Mann–Whitney U tests for the comparison of continuous data. We plotted the receiver operating characteristic (ROC curves) and calculated the area under the ROC curve (AUC) for each parameter. Results: Among 235 patients, 25 (%10.6) received a new diagnosis of CML. CML patients had significantly increased white blood cell count (WBC) with differential. Absolute basophil count showed the highest area under the ROC curve (AUC) value of 0.829, which had a cut-off value of 0.3 × 103/ µL. 76.00% of CML cases had an absolute basophil count of ≥0.3 × 103/µL, while 95.24% of the non-CML cases had an absolute basophil count of <0.3 × 103/µL. Conclusions: Our results indicate that an absolute basophil count of ≥0.3 × 103/µL can help improve BCR/ABL1 p210 test ordering and reduce healthcare costs.

Keywords:

CML, BCR/ABL1 fusion, RT-qPCR, CBC,

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