FISH panels for pediatric acute leukemias
AbstractBackground: Conventional cytogenetics is the gold standard in the diagnostic work up of acute leukemia patients. Due to a low mitotic index, lack of sample, and poor chromosome morphology, fluorescence in situ hybridization (FISH) is widely used as a complementary method to conventional cytogenetics. Additionally, some cryptic chromosomal rearrangements, which are crucial for stratification of patients, can be detected only by FISH. Different FISH panels are proposed to obtain comprehensive cytogenetic information. Methods: Recurrent chromosomal abnormalities were detected using commercially available FISH DNA probes. Results: In 85 % of pediatric AL patients conventional cytogenetics was successfully completed, revealing chromosomal rearrangements in half of them. We introduce an algorithm for inclusion of FISH DNA probes into panel, which is based on cytomorphology and immunophenotype of leukemic blasts. Using these panels, a particular cytogenetic marker was determined in 70 % of tested samples. The difference is even more prominent in B-ALL where conventional cytogenetics is less efficient. The frequency of a particular recurrent aberration is comparable with literature data in general, although some discrepancies were observed. Besides the detection of targeted rearrangements, FISH panels frequently show additional chromosomal changes with defined diagnostic and prognostic significance. Conclusions: The proposed algorithm for inclusion of DNA-probes into FISH panels is particularly efficient in children with B-ALL. In addition, presented results confirm this approach as an appropriate in different leukemias.
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