Molecular Monitoring of patients with Chronic Myeloid Leukemia (CML) in the state of Qatar: Optimization of Techniques and Response to Imatinib

Most cases of chronic myeloid leukemia (CML) are associated with the presence of BCR-ABL1 fusion gene; a molecular anomaly that introduced targeting therapy to CML. This study was setup primarily to optimize the real-time quantification detection of BCR-ABL1 transcripts, in order to pave the way for using this method as a diagnostic tool to support the clinical management of CML patients in Qatar. A secondary objective was to evaluate the response of CML patients to Imatinib (IM) and exploit adaption of this technique as an indicator of emerging drug resistance reported in Qatar. Peripheral blood (PB) samples from 26 CML patients receiving Imatinib, were analysed via serial Real-time quantitative polymerase chain reaction (RT-qPCR) to monitor the ratio of BCR-ABL1 to normal ABL1 transcripts. EuropeanLeukemia Net (ELN) 2006 and 2009 guidelines were employed to assess the molecular response to Imatinib. For patients to be classified as optimal responders, major molecular response (MMR) had to be achieved by 18 months of treatment. 1 Patients responding to Imatinib achieved major molecular response (MMR) during the 1st year of treatment; while patients who resisted Imatinib treatment did not achieve any molecular response within this time frame. This was the first molecular study to evaluate the molecular response of CML patients (citizens and residents) to IM in Qatar.