1
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Dridi W, Kanfar S, Sleiman PMA, Liu Y, Hakonarson H, Rammah H, Matrouk A. Saudi Arabian CML patient with a novel four-way translocation at t(9;22;5;2)(q34;q11.2;p13;q44). Mol Genet Genomic Med 2022; 10:e1865. [PMID: 35543309 PMCID: PMC9184659 DOI: 10.1002/mgg3.1865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 09/07/2021] [Accepted: 09/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The vast majority of chronic myeloid leukemia (CML) patients have a single translocation t(9;22)(q34;q11), BCR/ABL1 fusion genes, which is regarded as the hallmark of CML. However, around 5 to 10% of CML patients exhibit the involvement of a third chromosome. In some very rare cases a fourth or even fifth chromosome can be involved with the t(9;22). METHODS This case report is based on a 40-year-old Saudi Arabian male patient, diagnosed with CML in lymphoid blast crisis, and observed to have a four-way 46 XY, t(9;22;5;2)(q34;q11.2;p13;q44) translocation. The BCR/ABL1 fusion was identified by fluorescent in situ hybridization (FISH). Additionally, the BCR/ABL1 p210 mRNA fusion transcripts were identified by a molecular test. RESULTS The clinical and prognostic impact of additional partner chromosomes to t(9;22) remains unknown. The CML patient with this novel four-way translocation t(9;22;5;2) progressed to blast crisis and was resistant to Tyrosine Kinase Inhibitor (TKI) therapy. Therefore, this case is more in alignment with the negative impact of additional partner chromosomes to the translocation at t(9;22). CONCLUSION Here we report for the first time a novel four-way translocation at t(9;22;5;2)(q34;q11.2;p13;q44).
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Affiliation(s)
- Walid Dridi
- Cytogenetics Unit, Pathology and Laboratory Medicine Department, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | - Solaf Kanfar
- Hemato-Oncology Adult Department, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | - Patrick M A Sleiman
- The Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yichuan Liu
- The Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Hakon Hakonarson
- The Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hayaal Rammah
- Cytogenetics Unit, Pathology and Laboratory Medicine Department, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | - Alia Matrouk
- Cytogenetics Unit, Pathology and Laboratory Medicine Department, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
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2
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Buhagiar A, Borg J, Ayers D. Overview of current microRNA biomarker signatures as potential diagnostic tools for leukaemic conditions. Noncoding RNA Res 2020; 5:22-26. [PMID: 32110743 PMCID: PMC7033436 DOI: 10.1016/j.ncrna.2020.02.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/07/2020] [Accepted: 02/08/2020] [Indexed: 02/06/2023] Open
Abstract
Haematological malignancies encompass all variations of leukaemia at both the chronic and acute level, together with the specific cell type induced into tumourigenesis. Current diagnostic protocols for leukaemic conditions rely heavily on cytomorphology and other histological examinations from bone marrow aspirates, with the latter being a highly invasive surgical procedure for the patient. The discovery of microRNAs as one of the key gene regulatory networks in the past two decades has enabled researchers to investigate the possibility of exploiting the identification of dysregulated expression profiles for specific microRNAs present in the leukaemic patient's bloodstream as novel liquid biopsy diagnostic tools. This review article serves to consolidate recent global research efforts aiming to achieve such scopes.
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Affiliation(s)
- Alfred Buhagiar
- Faculty of Medicine and Surgery, University of Malta, Msida, MSD 2080, Malta
| | - Joseph Borg
- Faculty of Health Sciences, University of Malta, Msida, MSD 2080, Malta
| | - Duncan Ayers
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, MSD2080, Malta
- Faculty of Biology, Medicine and Health Sciences, The University of Manchester, Manchester, M13 9PL, United Kingdom
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3
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Reddy P, Shankar R, Koshy T, Radhakrishnan V, Ganesan P, Jayachandran PK, Dhanushkodi M, Mehra N, Krupashankar S, Manasa P, Nagare RP, Swaminathan R, Kannan K, Sagar TG, Ganesan TS. Evaluation of Cytogenetic Abnormalities in Patients with Acute Lymphoblastic Leukemia. Indian J Hematol Blood Transfus 2019; 35:640-648. [PMID: 31741615 DOI: 10.1007/s12288-019-01123-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 04/06/2019] [Indexed: 11/25/2022] Open
Abstract
Acute lymphoblastic leukemia (ALL) accounts for 20% of all adult leukemias and is the most common leukemia during childhood (80%). We present data on cytogenetics of ALL from a tertiary centre in India correlating it with clinical factors. Karyotyping of bone marrow samples of 204 patients with newly diagnosed ALL was performed with standard G-banding technique. Clinical data of patients was obtained from case records. Survival was estimated using Kaplan-Meir curves and compared by the log-rank test. Univariate and multivariate analysis was done for survival with age, sex, immunophenotype, hyperleukocytosis, risk type, remission status and cytogenetics. The most common karyotypes observed were normal in 39.7% (N = 81), hyperdiploidy in 12.7% (N = 26), t(9;22) in 4.4% (N = 9), t(1;19) in 3.9% (N = 8). Adults with ALL had worse survival compared with pediatric patients (HR 3.62; 2.03-6.45 95% CI, p < 0.001). Patients not in morphologic remission after induction chemotherapy fared poorly (HR 4.86; 2.67-8.84 95% CI, p < 0.001). Patients with favourable cytogenetics had better overall survival (HR 0.36; 0.12-1.05 95% CI, p < 0.05). On multivariate analysis, achievement of morphologic remission emerged as single most significant predictor of survival (p < 0.001). MLL gene rearrangement and t(12;21) were seen less commonly as compared to Western data. However, incidence rates of various cytogenetic abnormalities were similar to that reported from other centres from India. Age, morphologic remission at end of induction chemotherapy and favourable cytogenetics correlated significantly with survival.
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Affiliation(s)
- Pavan Reddy
- 1Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, 600020 India
| | - Ramesh Shankar
- 2Laboratory for Cancer Biology, Departments of Medical Oncology and Clinical Research, Cancer Institute (WIA), Adyar, Chennai, India
| | - Teena Koshy
- 3Department of Human Genetics, Sri Ramachandra University, Porur, Chennai, 600 116 India
| | | | - Prasanth Ganesan
- 1Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, 600020 India
| | - P K Jayachandran
- 1Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, 600020 India
| | | | - Nikita Mehra
- 1Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, 600020 India
| | - S Krupashankar
- 1Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, 600020 India
| | - P Manasa
- 2Laboratory for Cancer Biology, Departments of Medical Oncology and Clinical Research, Cancer Institute (WIA), Adyar, Chennai, India
| | - R P Nagare
- 2Laboratory for Cancer Biology, Departments of Medical Oncology and Clinical Research, Cancer Institute (WIA), Adyar, Chennai, India
| | - R Swaminathan
- 4Division of Epidemiology and Cancer Registry, Cancer Institute (WIA), Adyar, Chennai, India
| | | | - T G Sagar
- 1Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, 600020 India
| | - T S Ganesan
- 1Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, 600020 India
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4
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Al-Khallaf H, Alali H, Alkhatti A. Precursor B cell lymphoid blast crisis of chronic myeloid leukemia with novel chromosomal abnormalities: A case report. Oncol Lett 2018; 16:6691-6696. [PMID: 30405810 DOI: 10.3892/ol.2018.9497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 03/19/2018] [Indexed: 11/06/2022] Open
Abstract
Chronic myeloid leukemia (CML) is a clonal hematopoietic stem cell disorder. It is characterized by the presence of the Philadelphia (Ph) chromosome, t(9;22)(q34.1;q11.2), which carries the BCR-ABL1 fusion gene. Tyrosine kinase inhibitors (TKIs) have markedly changed the treatment approach of CML and have become the first-line agents for almost all CML patients. However, certain patients experience resistance to these medications, which occurs through several mechanisms, including the accumulation of TKI-resistant chromosomal abnormalities. The present study reports a case of a 27-year-old Saudi male with CML receiving TKI treatment, who presented with precursor B-cell lymphoblastic crisis demonstrating the presence of the novel combined chromosomal abnormalities; non-Ph der(22), i(9) and der(20), carrying the BCR-ABL1 fusion gene. This case report adds to the literature on novel TKI-resistance-conferring chromosomal abnormalities and links them to precursor B-cell lymphoblastic crisis.
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Affiliation(s)
- Hamoud Al-Khallaf
- Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
| | - Hani Alali
- Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
| | - Adil Alkhatti
- Cancer Institute, Johns Hopkins Aramco Healthcare, Dhahran 34465, Saudi Arabia
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Asif M, Hussain A, Wali A, Ahmad N, Sajjad N, Amir M, Ali I, Pushparaj PN, Rasool M. A rare case of three-way complex variant translocation in chronic myeloid leukemia t(6;9;22)(p21;q34;q11): A case report. Biomed Rep 2017; 7:377-379. [PMID: 29085635 DOI: 10.3892/br.2017.967] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 07/20/2017] [Indexed: 11/05/2022] Open
Abstract
Philadelphia (Ph)-positive chromosome or Ph translocation has been recognized in 90-95 chronic myeloid leukemia (CML) cases worldwide. However, only 5-8% CML patients show complex variant translocations. In the present study, hematological tests for a 47-year-old female CML patient were performed to determine the hemoglobin, platelets and total leukocyte values. A FISH test was carried out to recognize the BCR/ABL gene fusion, and a cytogenetic analysis was performed. The hematological results showed an increase in WBC (414000/mm3) and a decrease in hemoglobin (8.9 mg/dl), indicating the anemic condition in the CML patient. Furthermore, cytogenetic karyotyping results showed 46,XX,t(6;9;22)(p21;q34;q11) and positive for Ph chromosome. In conclusion, in the present study, we report a rare three-way complex variant translocation in a CML patient.
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Affiliation(s)
- Muhammad Asif
- Department of Biotechnology, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta 87300, Pakistan
| | - Abrar Hussain
- Department of Biotechnology, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta 87300, Pakistan
| | - Abdul Wali
- Department of Biotechnology, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta 87300, Pakistan
| | - Nazeer Ahmad
- Department of Biotechnology, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta 87300, Pakistan
| | - Naheed Sajjad
- Department of Biotechnology, Sardar Bahadur Khan Women's University, Quetta 87500, Pakistan
| | - Muhammad Amir
- Department of Biotechnology, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta 87300, Pakistan
| | - Irfan Ali
- Akhuwat Faisalabad Institute of Research Science and Technology, Faisalabad 38000, Pakistan
| | - Peter Natesan Pushparaj
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah 21589, Kingdom of Saudi Arabia
| | - Mahmood Rasool
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah 21589, Kingdom of Saudi Arabia
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6
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Lee J, Kim DS, Lee HS, Choi SI, Cho YG. A novel t(9;22;11) translocation involving 11q24 in a patient with chronic myeloid leukemia: A case report. Oncol Lett 2017; 13:1711-1713. [PMID: 28454313 PMCID: PMC5403192 DOI: 10.3892/ol.2017.5668] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 12/02/2016] [Indexed: 11/06/2022] Open
Abstract
Variant Philadelphia chromosome translocations involving chromosomes other than 9 and 22 have been reported in 5–10% of patients with chronic myeloid leukemia (CML). As part of the three-way variant t(9;22;11) in patients with CML, 11q24 is a novel region that has not previously been investigated. A 22-year-old male exhibiting chronic phase CML developed a recurrence of the same phase subsequent to the interruption of imatinib treatment and showed the same chromosomal abnormality, t(9;22;11)(q34;q11.2;q24), that was detected at the initial diagnosis. The recurrent CML responded well to imatinib therapy. These findings suggest that the three-way variant, t(9;22;11), involving 11q24 may be associated with a good prognosis and response to imatinib. This is the first report of three-way variant involving 11q24 in a patient with CML.
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Affiliation(s)
- Jaehyeon Lee
- Department of Laboratory Medicine, Chonbuk National University Medical School, Jeonju, Jeollabuk-do 54907, Republic of Korea
| | - Dal Sik Kim
- Department of Laboratory Medicine, Chonbuk National University Medical School, Jeonju, Jeollabuk-do 54907, Republic of Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Jeollabuk-do 54907, Republic of Korea
| | - Hye Soo Lee
- Department of Laboratory Medicine, Chonbuk National University Medical School, Jeonju, Jeollabuk-do 54907, Republic of Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Jeollabuk-do 54907, Republic of Korea
| | - Sam Im Choi
- Department of Laboratory Medicine, Chonbuk National University Medical School, Jeonju, Jeollabuk-do 54907, Republic of Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Jeollabuk-do 54907, Republic of Korea
| | - Yong Gon Cho
- Department of Laboratory Medicine, Chonbuk National University Medical School, Jeonju, Jeollabuk-do 54907, Republic of Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Jeollabuk-do 54907, Republic of Korea
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7
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Asif M, Hussain A, Rasool M. A rare case of a three way complex variant positive Philadelphia translocation involving chromosome (9;11;22)(q34;p15;q11) in chronic myeloid leukemia: A case report. Oncol Lett 2016; 12:1986-1988. [PMID: 27602125 DOI: 10.3892/ol.2016.4821] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 12/02/2015] [Indexed: 11/05/2022] Open
Abstract
The t(9;22)(q34;q11) translocation is present in 90-95% of patients with chronic myeloid leukemia (CML). Variant complex translocations have been observed in 5-8% of CML patients, in which a third chromosome other than (9;22) is involved. Imatinib mesylate is the first line breakpoint cluster region-Abelson gene (BCR/ABL)-targeted oral therapy for CML, and may produce a complete response in 70-80% of CML patients in the chronic phase. In the present study, a bone marrow sample was used for conventional cytogenetic analysis, and the fluorescence in situ hybridization (FISH) test was used for BCR/ABL gene detection. A hematological analysis was also performed to determine the white blood cell (WBC) count, red blood cell count, hemoglobin levels, packed and mean cell volumes, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and platelet values of the patient. The hematological analysis of the patient indicated the increased WBC of 186.5×103 cells/µl, and decreased hemoglobin levels of 11.1 g/dl. The FISH test revealed that 67% cells demonstrated BCR/ABL gene translocation. The patient was treated with 400 mg imatinib mesylate daily, and was monitored at various intervals over a 6-month period. The present study reports the rare case of a patient that demonstrates a three-way Philadelphia chromosome-positive translocation involving 46XY,t(9;11;22)(q34;p15;q11)[10], alongside CML in the chronic phase. The translocation was analyzed using cytogenetic and FISH tests.
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Affiliation(s)
- Muhammad Asif
- Department of Biotechnology and Informatics, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta, Balochistan 87300, Pakistan; Office of Research Innovation and Commercialization, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta, Balochistan 87300, Pakistan
| | - Abrar Hussain
- Department of Biotechnology and Informatics, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta, Balochistan 87300, Pakistan
| | - Mahmood Rasool
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Makkah 21589, Saudi Arabia
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8
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Pehlivan M, Sahin HH, Pehlivan S, Ozdilli K, Kaynar L, Oguz FS, Sever T, Yilmaz M, Eser B, Ogret YD, Kis C, Okan V, Cetin M, Carin M. Prognostic importance of single-nucleotide polymorphisms in IL-6, IL-10, TGF-β1, IFN-γ, and TNF-α genes in chronic phase chronic myeloid leukemia. Genet Test Mol Biomarkers 2014; 18:403-9. [PMID: 24819026 PMCID: PMC4043362 DOI: 10.1089/gtmb.2014.0011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to explore the association between polymorphisms of five cytokine genes and clinical parameters in patients with Philadelphia-positive (Ph+) chronic myeloid leukemia (CML) treated with imatinib. We analyzed five cytokine genes (interleukin [IL]-6, IL-10, gamma interferon [IFN-γ], transforming growth factor beta-1 [TGF-β1], and tumor necrosis factor-alpha [TNF-α]) in 60 cases with Ph+ CML and 74 healthy controls. Cytokine genotyping was performed by the polymerase chain reaction-sequence-specific primer. All data were analyzed using the de Finetti program and SPSS version 14.0 for Windows. No significant differences were detected between the CML group and healthy controls with respect to the distributions and numbers of genotypes and alleles in TNF-α, TGF-β1, IL-10, and IFN-γ. However, the GG genotype associated with high expression in IL-6 was found to be significantly more frequent in CML as compared to controls (p=0.010). The median follow-up time was 49.3 months (range 6.1-168.4) and the median duration of imatinib treatment was 39.5 months (range 5.2-103.4) for these patients. On multivariateanalysis, only IL-10 GCC/GCC highly produced haplotypes were significantly associated with a shorter event-free survival. The relationship between cytokine genotypes/haplotypes and clinical parameters in CML has not been investigated before. Our results suggest that IL-10 may be a useful marker for CML prognosis and theGG genotype of the IL-6 gene may be associated with susceptibility.
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Affiliation(s)
- Mustafa Pehlivan
- Department of Hematology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | | | - Sacide Pehlivan
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Kursat Ozdilli
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Medipol University Hospital, Istanbul, Turkey
| | - Leylagul Kaynar
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Fatma Savran Oguz
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tugce Sever
- Department of Hematology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Mehmet Yilmaz
- Department of Hematology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Bulent Eser
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Yeliz Duvarci Ogret
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Cem Kis
- Department of Hematology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Vahap Okan
- Department of Hematology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Mustafa Cetin
- Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mahmut Carin
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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