[VIRTUAL] EVALUATION OF CONVENTIONAL KARYOTYPE AND IN SITU HYBRIDATION BY FLUORESCENCE IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA NOT MUTTED TO THE IGHV GENE (HEMO 2021)
Introduction The search for somatic hypermutation of the IGHV gene, together with karyotype analysis and fluorescence in situ hybridization (FISH), are valuable resources for the prognostic stratification in chronic lymphocytic leukemia (CLL). About 80% of CLL cases have genetic alterations that correlate with prognosis.Objective To correlate alterations detected by karyotype and FISH in patients not mutated to the IGHV gene and to evaluate the importance of combining these findings.Methodology Thirty blood samples were analyzed peripheral or bone marrow of patients with CLL. Molecular testing for IGHV was performed by reverse transcription and amplification of the mRNA corresponding to the IGHV gene, followed by sequencing and database comparison. Karyotyping was performed by means of culture stimulated with mitogens B and/or oligo, and FISH used probes for MY B, cen12, IGH, RB1, ATM and TP53. Result 7 (23.33%) patients had complex karyotype ( ≥3 changes) and abnormal FISH that complemented each other; 7 (23.33%) patients had trisomy 12 in both tests; 5 (16.67%) demonstrated a normal karyotype with altered FISH (deletion of the MYB, TP53 and trisomy 12 genes). In 1 (3.33%) the 17p deletion was detected simultaneously in both tests; 1 (3.33%) had a rearrangement involving the long arm of chromosome 17; 4 (13.33%) had alterations involving one of the chromosomes: 4, 6, 11, 13 and 14 and one of the genes: MYB, ATM, RB1 and IGH. In 5 cases (16.67%), it was not possible to obtain viable metaphases in the karyotype, however FISH detected alterations involving one of the genes: ATM, RB1, IGH, TP53 and trisomy of chromosome 12.Conclusion Karyotype, FISH and IGHV carried out, simultaneously, showed relevant data for the prognostic stratification of patients with CLL. More than 50% of the detected alterations, both those found in the karyotype, such as cases with complex karyotype, and other alterations considered only in FISH, corroborated the literature, showing that they are equally unfavorable and of aggressive course, as is the case with presence of the non-mutated IGHV gene.