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Benchikh S, Charlène SSG, Bousfiha A, Razoki L, Aboulfaraj J, Zarouf L, Hamouchi AE, Malki A, Nassereddine S. Cytogenetic and epidemiological profile of chronic myeloid leukemia in Morocco. Ann Hematol 2024; 103:2765-2774. [PMID: 38653807 DOI: 10.1007/s00277-024-05747-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024]
Abstract
Chronic myeloid leukemia (CML) is a neoplastic disease of genetic origin resulting from clonal proliferation of hematopoietic stem cells (HSCs). The reciprocal translocation t(9;22)(q34;q11) is the main chromosomal abnormality involved in this pathology, usually detected by conventional cytogenetics. This article aims to investigate the epidemiological, cytogenetic, therapeutic, and clinical characteristics of Moroccan patients with CML. This research represents the first large-scale study of CML patients in Morocco and was carried out at Institut Pasteur of Morocco. Bone marrow samples were processed for cytogenetic analysis, and karyotypes were described according to an international system of human cytogenetic nomenclature (ISCN 2016). Patients were studied according to their epidemiological characteristics, clinical information and cytogenetic results. For statistical calculations, R version 4.3.1 was used to analyze the data and calculate the statistical parameters. RStudio and Power BI were used for data visualization. The National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) method of incidence estimation was used to calculate our incidence. We received 826 patients (from 1992 to 2023) who were referred for suspected CML or who were undergoing treatment. Only 650 patients with confirmed CML were included in the study, all of whom underwent their first cytogenetic test. The median age of our patients was 45 years and the sex ratio was 1.03. At the time of diagnosis, 147 (30%) of the patients had clinical manifestations. Most patients were diagnosed in the chronic phase (94.5%). Nineteen complex variant translocations of the Philadelphia (Ph) chromosome were detected. At the time of diagnosis, 55 (11.5%) patients had ACAs, of which 30 (54.5%) were high-risk ACAs. Based on data from 174 patients treated with imatinib, the median time to complete cytogenetic response (CCyR) was 11 months, and at the last cytogenetic follow-up, 81 patients (46.6%) achieved CCyR, while 64 patients (36.8%) showed no response to treatment. Regarding adherence to European LeukemiaNet (ELN) guidelines, 58 patients (33%) were followed according to these guidelines, with optimal treatment in 8.6%, suboptimal treatment in 7% and treatment failure in 18%. The estimated incidence of chronic myeloid leukemia calculated is 0.6 cases per 100,000 in the Casablanca region. This study provides a detailed overview of CML in Morocco, highlighting important clinical, cytogenetic and therapeutic aspects despite some limitations. It also highlights the need to deepen our understanding of this complex disease for disease management in our specific context.
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MESH Headings
- Humans
- Morocco/epidemiology
- Male
- Female
- Middle Aged
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/epidemiology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Adult
- Aged
- Adolescent
- Young Adult
- Child
- Cytogenetic Analysis
- Translocation, Genetic
- Aged, 80 and over
- Incidence
- Child, Preschool
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Affiliation(s)
- Sara Benchikh
- Laboratory of Cytogenetics, Pasteur Institute of Morocco, Casablanca, Morocco.
- Laboratory of Physiopathology and Molecular Genetics, Faculty of Sciences Ben M'Sik, Hassan II University, Casablanca, Morocco.
| | - Soro Somda Georgina Charlène
- Laboratory of Cytogenetics, Pasteur Institute of Morocco, Casablanca, Morocco
- Laboratory of Biology and Health, Faculty of Sciences Ben M'sik, Casablanca, Morocco
| | - Amale Bousfiha
- Laboratory of Physiopathology and Molecular Genetics, Faculty of Sciences Ben M'Sik, Hassan II University, Casablanca, Morocco
| | - Lunda Razoki
- Laboratory of Cytogenetics, Pasteur Institute of Morocco, Casablanca, Morocco
| | - Jamila Aboulfaraj
- Laboratory of Cytogenetics, Pasteur Institute of Morocco, Casablanca, Morocco
| | - Latifa Zarouf
- Laboratory of Cytogenetics, Pasteur Institute of Morocco, Casablanca, Morocco
| | - Adil El Hamouchi
- Laboratory of Cytogenetics, Pasteur Institute of Morocco, Casablanca, Morocco
| | - Abderrahim Malki
- Laboratory of Physiopathology and Molecular Genetics, Faculty of Sciences Ben M'Sik, Hassan II University, Casablanca, Morocco
| | - Sanaa Nassereddine
- Laboratory of Cytogenetics, Pasteur Institute of Morocco, Casablanca, Morocco
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