Analysis of class I and II aberrations in Iraqi childhood acute myeloid leukemia using filter paper cards

作者：Al Kzayer Lika'a Fasih Y; Uyen Le Thanh N; Al Jadiry Mazin Faisal; Al Hadad Salma Abbas; Al Badri Safaa A Faraj; Ghali Hasanein Habeeb; Ameen Najiha Ahmed; Liu Tingting; Matsuda Kazuyuki; Abdulkadhim Jaafar M H; Al Shujairi Tariq Abadi; Matti Zead Ismael I K; Hasan Janan Ghalib; Al Abdullah Hussam M Salih; Al Ani Mouroge H; Saber Paiman Ali I; Khalil Hisham Maree; Inoshita Toshi; Kamata Minoru; Koike Kenichi; Sakashita Kazuo^*

来源：Annals of Hematology, 2014, 93(6): 949-955.

DOI：10.1007/s00277-014-2007-2

• FTA cards
• AML
• Class I/II aberrations
• FLT3
• APL
• NPM1

The lack of molecular diagnosis in the field of cancer in Iraq has motivated us to perform a genetic analysis of pediatric acute myelogenous leukemia (AML), including class I and II aberrations. Peripheral blood or bone marrow cells were collected from 134 AML children aged a parts per thousand currency sign15 years. Flinders Technology Associates (FTA) filter paper cards were used to transfer dried blood samples from five Iraqi hospitals to Japan. DNA sequencing was performed to identify class I mutations. Nested RT-PCR was used to detect class II aberrations, except that MLL rearrangement was detected according to long distance inverse-PCR. NPM1 and FMS-like tyrosine kinase 3-internal tandem duplication (FLT3-ITD) mutations were analyzed by GeneScan using DNA template. Among 134 Iraqi pediatric AML samples, the most prevalent FAB subtype was M2 (33.6 %) followed by M3 (17.9 %). Class I mutations: 20 (14.9 %), 8 (6.0 %), and 8 (6.0 %) patients had FLT3-ITD, FLT3-TKD, and KIT mutations, respectively. Class II mutations: 24 (17.9 %), 19 (14.2 %), and 9 (6.7 %) children had PML-RARA, RUNX1-RUNX1T1, and CBFB-MYH11 transcripts, respectively. MLL rearrangements were detected in 25 (18.7 %) patients. NPM1 mutation was detected in seven (5.2 %) cases. Collectively, approximately 30 % of AML children were proved to carry favorable prognostic genetic abnormalities, whereas approximately 10 % had high FLT3-ITD allelic burden and needed a special treatment plan including allogeneic hematopoietic stem cell transplantation. Acute promyelocytic leukemia (APL) was frequent among Iraqi pediatric AML. It is likely that molecular diagnosis using FTA cards in underdeveloped countries could guide doctors towards an appropriate treatment strategy.

• 出版日期2014-6