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Qualitative and quantitative evaluation of the BCR-ABL fusion gene in chronic Myelogenous Leukemia by flourescence in situ hybridization and molecular genetic methods

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Aims: Fluorescence in situ hybridization (FISH) and quantitative real-time polymerase chain reaction (QRT-PCR) were used to diagnose or screen for minimal residual disease (MRD) in Philadelphia (Ph) chromosome-positive leukemia. We compared the diagnostic utility of FISH and QRT-PCR at various time points in the course of chronic myelogenous leukemia (CML) and to determine the mean initial values for patients whose QRT-PCR results were not known at the time of diagnosis. Results: We analyzed 135 results for 78 CML patients tested by FISH and QRT-PCR for the Ph chromosomal translocation. All newly diagnosed cases were positive by both methods. On follow-up following treatment, 1 case was FISH positive and QRT-PCR negative; 61 cases were FISH negative and QRT-PCR positive. Overall concordance was 54.1%. There was good concordance between QRT-PCR results and cytogenetic response categories. Conclusions: We confirmed that QRT-PCR allows precise measurement of low levels of BCR-ABL transcripts and can serve as a sensitive indicator of MRD. We also demonstrated 100% correlation between QRT-PCR and FISH in newly diagnosed CML.

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Chronic myeloid-leukemia, Polymerase-chain-reaction, Rt-PCR, Follow-up, Positive leukemias, Peripheral-blood, Interferon-alpha, Residual disease, Fish, Cytogenetics, Biochemistry & molecular biology, Genetics & heredity

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