Molecular and Hematological Characterizations of Acquired Alpha Tlialathemia among Sudanese leukemic Patients

Abstract

Backgroimd: Acquired alpha thalassemia (hemoglobin ll (llbll) disease) is a rare complication of neoplastic chronic myeloid disorders especially myelodysplastic syndrome and other types of leukemia. The association between alpha thalassemia and leukemia type or prognosis is defined by the presence of llbll inclusion which indicated by down regulation of alpha globin gene expression. tlbjective: This study aims to detemrine the frequency of the acquired alpha thalassemia (llbll disease) among Sudanese leukemic patients and studying the hematological and molecular characteristics features of this disorder. Materials and 1'/lethodszlliis descriptive study includes 135 Sudanese leukemic patients having different types of leukemia, male and female with various age groups was enrolled in different hematological and molecular tests. One blood sample was collected in (EDTA) anticoagulated container from each patient in order to perfomi a complete blood count, llbll detection and for molecular analysisThe CBC was performed by automated (Sysmex 21), and Leishman stained blood films were examined to confirm the type of associated anemia. Blood films also prepared with BCB stain were used to detect llbll containing cells.RNA was extracted from the samples with positive llbll, converted to cl)NA and analyzed for alpha beta globin ratio using Real Time RT-PCR llesults:A total of 129 samples from Sudanese leukemic patients enrolled in this study for quantitation of alpha\beta ratio, llbll preparation and CBC. The frequency of the anemic patients among the population was 81.4 %, the NN anemia represents (58.9%) of the total anemic patients, the Mil and MN showed The W‘ Annual Conference amt g$J3““ L111-ll ¢=l--‘belt J43- Ministry Of Higher Education (4,,-41-it ¢~==\5L9 qt‘-11 all-lit UJJ) &Scientific Research (GCNU‘\) _ 9' - W/\ \'/\ -J 1— —- I 1 39.5%, 1.6% respectively. lhe frequency of llbli inclusions among the study population was 27. % positive sample, the positive llbl'l preparation among each type of leukemia showed a higher frequency in Allll. (40.6%) followed by (35.0%) in Cllll. while showed lower results in lymphoid leukemia (22.0% in Al.l. and 18.5% in Cl.l.). lhe correlation was statistically significant Mth Allll. and ClYll..There was insignificant statistical correlation between llbll and gender, age, severity of anemia and the duration of leukemia."l'he molecular analysis showed that there were a reduction in alpha \beta globin synthesis ratios which associated with the hematologic changes and the presence of libll inclusion in leukemic patients (meano. 1 1¢SD 0.2) Couclusionszlhe findings of the present study show that the frequency of llbll inclusion among leukemic patients was 27.9% from Hie total population. There was a statistical significant correlation between the type of leukemia and the frequency of llbll inclusions. The alpha \beta ratio shows an observable reduction in all the positive cases.