Dr. Goswami Parth Rajendragiri
Pathology
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Patient's Query
Hi doctor,
My brother-in-law, aged 19 years, was diagnosed with B-cell acute lymphoblastic leukemia three years ago and was started on chemotherapy and showed a good response to steroids and chemotherapy. He completed his chemo and had eight fractions of cranial RT too. His treatment cycle was completed in six months, and he is now on his maintenance regimen. He is following BFM pediatric intermediate risk protocol. He will complete this maintenance protocol in two years. His chromosomal abnormalities are 14q+ , 17q+ , band q32 , isochromosome 17q and unusual t (7;15). Please note that his FISH TEST is negative for (9;22), and RTPCR is negative for BCR-ABL. He also underwent a laboratory investigation, and I have attached the reports for you to check. He is taking tablets Methotrexate and 6-Mercaptopurine. My questions are:
Will the above-mentioned chromosomes have any negative impact in the future? Are his chromosomes hyperdiploid or hypodiploid, or aneuploid? Which is better? Can you please enlighten me about the chromosomal status of my brother-in-law? Please enlighten your opinion on this.
Hello
Welcome to icliniq.com.
I thoroughly read your query and understand your concern.
The BFM (Berlin-Frankfurt-Munich) protocol is the standard protocol used nowadays for ALL (acute lymphocytic leukemia) cases, and it has shown a very good effect in inducing remission. So proper treatment has been given until now. The mentioned chromosome is not related to ALL prognosis, in my opinion. The chromosomal abnormalities t (4, 11) and t (1, 19), if detected, are associated with a bad prognosis that is not present here. Through molecular study, if hyper diploidy chromosomes are detected, then they are associated with a good prognosis. In ALL, if CNS (central nervous system) involvement is present, then the prognosis is bad. He has been BCR ABL (a genetic test) negative. Hence prognosis seems to be good.
I hope this information will be beneficial to you.
Continue treatment with your treating hemato-oncologist.
Take care.
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