Clinical spectrum and treatment response in patient of chronic myeloid leukemia in correlation with ABO blood group.

Background: Several studies have been conducted to evaluate and investigate the molecular mechanisms underlying alterations in ABO blood group antigens in oncogenesis. We observed that no study has been reported yet that correlate cytological, molecular and haematological responses of Imatinib therapy in chronic myeloid leukemia (CML) patients with different types of blood groups.

Objective: To determine the distribution of CML in the ABO blood group, clinical spectrum of CML in different blood groups, and treatment response of CML patients in correlation with ABO and Rh blood groups.

Material And Methods: All the patients included in the study were diagnosed on the basis of clinical features, peripheral smears and bone marrow aspiration findings. Real-time reverse transcriptase polymerase chain reaction (PCR) and cytogenetic analysis were done in all patients at the time of initiation of therapy. Blood grouping and Rh typing of each patient were done at the initiation of therapy.

Results: Out of 100 included patients, 58 were male and 42 were female patients. It was observed that 45 (45%) patients were having a B+ blood group; 33% patients were having O+ blood group, followed by A+ (10%), AB+ (8%), A- (2%), B- (1%) and AB- (1%). Around 43.64% study subjects with O + blood groups showed complete cytogenetic response, followed by B+ (41.82%), A+ (10.91), A- (1.82) and AB+ (1.82). An equal number of patients (40% each) with O+ and B+ blood groups, followed by A+ (20%) showed undetectable Abelson-breakpoint cluster region (BCR-ABL)/ratio (%). About 75% of patients showed complete haematological response (CHR) and 25% showed PHR. Patients with B+ and O+ blood groups (41.33%) showed a CHR. It was observed that a maximum number of patients were suffering from symptoms of an abdominal mass (37%), 43.24% of patients with B+ blood group showed an abdominal mass, followed by O+ (35.13%), A+ and AB+ (8.11% each), B - and AB- (2.70% each).

Conclusion: This study revealed that study subjects with B+ and O+ blood groups showed better cytogenetic, molecular and haematological responses as compared with patients with other blood groups at 6 and 12 months of treatment with Imatinib.