Tyrosine kinase domain mutations in chronic myelogenous leukemia patients: A single center experience

J Postgrad Med. 2022 Apr-Jun;68(2):93-97. doi: 10.4103/jpgm.JPGM_781_20.

Abstract

Introduction: Despite the impressive responses achieved with tyrosine kinase inhibitor (TKI) therapy, treatment resistance develops in 16-33% of patients of chronic myelogenous leukemia (CML). Of the BCR-ABL1 dependent mechanisms, mutations in the tyrosine kinase domain (TKD) are the commonest cause of resistance.

Material and methods: Allele specific oligonucleotide - polymerase chain reaction (ASO-PCR) was done for testing the six common TKD mutations, T315I, G250E, E255K, M244V, M351T, and Y253F.

Results and conclusion: TKD mutation study was done on 83 patients. Of these 44 (53%) were positive for one or more mutations. On analyzing specific mutations, E255K was the commonest mutation seen in 24 (29%) cases, followed by T315I in 23(28%) cases. Y253F mutation was not seen in the present study sample. In the present cohort of 83 patients, 29 (35%) cases were positive for single mutation, 12 (14%) had two mutations and 3 (4%) had three mutations.

Keywords: ASO-PCR; imatinib resistance; tyrosine kinase domain mutations.

MeSH terms

  • Antineoplastic Agents* / therapeutic use
  • Cohort Studies
  • Drug Resistance, Neoplasm / genetics
  • Fusion Proteins, bcr-abl / genetics
  • Fusion Proteins, bcr-abl / therapeutic use
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / drug therapy
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive* / genetics
  • Mutation

Substances

  • Antineoplastic Agents
  • Fusion Proteins, bcr-abl