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BCR-ABL1 transcript levels increase in peripheral blood but not in granulocytes after physical exercise in patients with chronic myeloid leukemia.

Artikel i vetenskaplig tidskrift
Författare Sofia Jönsson
Bob Olsson
Stefan Jacobsson
Lars Palmqvist
Anne Ricksten
Kerstin Ekeland-Sjöberg
Hans Wadenvik
Publicerad i Scandinavian journal of clinical and laboratory investigation
Volym 71
Nummer/häfte 1
Sidor 7-11
ISSN 1502-7686
Publiceringsår 2011
Publicerad vid Institutionen för biomedicin, avdelningen för klinisk kemi och transfusionsmedicin
Institutionen för medicin, avdelningen för invärtesmedicin
Sidor 7-11
Språk en
Länkar dx.doi.org/10.3109/00365513.2010.52...
Ämnesord Chronic myeloid leukemia, imatinib, BCR-ABL, complete cytogenetic remission, reverse transcriptase polymerase chain reaction, exercise
Ämneskategorier Molekylärbiologi, Hematologi, Klinisk kemi

Sammanfattning

Abstract In chronic myeloid leukemia (CML) treatment response is determined by measurements of BCR-AB1L transcripts in peripheral blood by quantitative real-time PCR (qRT-PCR) and a 2-5 fold increase is considered a warning sign. The BCR-ABL1 gene is mainly expressed in myeloid cells whereas quantification of BCR-ABL1 is performed on the nucleated cell fraction of peripheral blood. Hence, leukocyte composition of the nucleated cell fraction may affect the result of BCR-ABL1 quantification. The aim of this study was to investigate if changes in leukocyte composition of peripheral blood had any effect on BCR-ABL1 transcript levels in CML patients. Six CML patients in complete cytogenetic remission (CCgR) performed a maximal physical exercise test. Blood samples were collected before exercise, at maximal exhaustion and after exercise. A biphasic increase in leukocyte count was observed and the relative proportion of granulocytes in peripheral blood changed significantly after exercise compared with baseline (p < 0.001). The BCR-ABL1 transcript level increased significantly following exercise, in nucleated cell fraction of peripheral blood (p < 0.05) but not in isolated granulocytes. In the nucleated cell fraction, the mean BCR-ABL1 transcript level was 3.3-fold (range 0.7-6.8) higher 180 min after exercise compared with baseline (p < 0.01). In conclusion, physical exercise induced significant increases in BCR-ABL1 transcript levels concomitant with changes in leukocyte content of peripheral blood. We therefore suggest that variations in leukocyte composition of peripheral blood, causing pre-analytic variations that affect BCR-ABL1 quantification, have to be accounted for. Consequently, small variations in BCR-ABL1 transcript levels should be interpreted cautiously in CML patients in CCgR.

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