Sisay, H/mariam Temesgen (2017) Prognostic Importance of Lactate Dehydrogenase and Uric Acid as Compared to Breakpoint Cluster Region-Abelson Transcript Level among Chronic Myeloid Leukemia Patients in Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia. Masters thesis, Addis Ababa University.
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Abstract
Background: Chronic myeloid leukemia (CML) is characterized by the presence of Philadelphia (Ph) chromosome, which results from by the breakpoint cluster region-Abelson (BCR-ABL) fusion gene. Increasing levels of BCR-ABL are strongly predictive of cytogenetic and hematologic relapse. However, this molecular test for BCR-ABL is readily available in the developed world and rarely available in low and middle-income countries, which is also limited in access and very expensive to afford. As a result of this, serum LDH and uric acid estimations, which are easily available and cost effective, have gained considerable appreciation as valuable prognostic markers of CML. Objectives: To evaluate prognostic importance of total LDH and uric acid as compared to breakpoint cluster region-Abelson (BCR-ABL) transcript level in chronic myeloid leukemia (CML) patients among treated and treatment naive patients. Methods: A cross- sectional study was carried out from January to March 2017 at Tikur Anbessa specialized hospital in Addis Ababa. Convenient sampling method was used to include eighty one (81) CML patients from those who came for testing GeneXpert RT-PCR transcript level. We studied the correlation between 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 were assayed 46(56.8%), medication treated group and the remaining 35 (43.2%) are treatment naive patients. Significant positive correlations were observed between LDH and BCR-ABL (r=0.79, P<0.001). The correlation coefficient value of (r=0.295, p<0.008) indicated that weak correlation exists between uric acid and BCR-ABL. Strong correlation were observed between LDH and hematological parameters: WBC, lymphocyte and Basophil (r=0.73, p<0.001), (r=-0.61<0.001), (r=0.75, p<0.001) respectively. No significant correlation of LDH and platelet count (r=0.24, p<0.069).There was statistically significant (p<0.001) 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. 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: CML LDH value strongly correlated with BCR-ABL transcript level whereas uric acid was weakly correlated with BCR-ABL therefore; LDH could serve as an alternative cost effective prognostic biomarker to follow-up in those patients.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Chronic Myeloid leukemia, LDH, Uric acid, BCR-ABL, WBC, platelets, RBC, hemoglobin |
| Subjects: | Q Science > QD Chemistry R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
| Divisions: | Africana |
| Depositing User: | Emmanuel Ndorimana |
| Date Deposited: | 26 Jul 2018 07:29 |
| Last Modified: | 26 Jul 2018 07:29 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/8174 |
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