BCR-ABL Transcript Level as Compared to LDH and Uric Acid Among Chronic Myeloid Leukemic Patients.

BACKGROUND Chronic myeloid leukemia is characterized by the presence of Phila¬delphia chromosome, which caused by the breakpoint cluster region-Abelson fusion or joined gene. High concentration of BCR-ABL transcripts level can strongly forecast cytogenetic and hematologic reversion in CML patients. However, this molecular test for BCR-ABL is costly and hardly available in developing countries with low and middle-income. Owing to this, it is required to examine other cost effective and best diagnostic (prognostic) biomarker. OBJECTIVE The present study was intended on the estimation of total LDH and uric acid level as compared to BCR-ABL transcript level among treated and treatment naive Chronic Myeloid Leukemia (CML) patients. METHODS A comparative cross- sectional study design was used to include eighty one (81) CML patients and tested for BCR-ABL by GeneXpert RT-PCR transcript level at Tikur Anbessa Specialized Hospital. The current study correlates LDH with BCR-ABL and hematological parameters using spearman correlation, Mann-Whitney U test and roc curve data analysis tool. RESULT A total of 81 CML patients was assayed; 46(56.8%) of them were medically treated group and the remaining 35 (43.2%) were treatment naive patients. Significant positive correlations were observed between LDH and BCR-ABL (r = 0.79, P < 0.001). The correlation coefficient value of uric acid (r = 0.295, p < 0.008) with BCR-ABL showed that weak correlation which exists between the two test parameter. There was statistically noteworthy (p < 0.05) difference in the median level of BCR-ABL and LDH among patients on treatment group (median = 21%, 350U/L) and treatment naive group (median = 57%, 1246U/L), respectively. For uric acid there was no statistically significant (p < 0.542) difference between the study group. The AUC for LDH, Basophil and WBC 0.881, 0.889, and 0.748 respectively, showed better performance for the follow-up of patients with CML compared with uric acid (0.695) and platelets (0.70). CONCLUSION AND RECOMMENDATION The CML LDH value strongly correlated with BCR-ABL transcript level, whereas uric acid was weakly correlated with BCR-ABL. Hence; In Parallel with BRC-ABL transcript level, these findings could be a patent for confirming the capability of LDH as an alternative cost effective diagnostic, prognostic biomarker and a novel therapeutic target in CML disease.