Megakaryocytic Clustering in Chronic Myeloid Leukemia: Can it be a Predictor of Clinical Outcome?

Abstract

OBJECTIVE\nTo compare clinical outcome in patients of chronic myeloid leukemia (CML) with and without megakaryocytic clustering.\n\n\nSTUDY DESIGN\nCross-sectional comparative study.\n\n\nPLACE AND DURATION OF STUDY\nPathology Department and CML Clinic Oncology Department, King Edward Medical University from March 2018 to March 2019.\xa0 Methodology: Ninety-four patients diagnosed with chronic phase of CML were included. Complete record of complete blood count, splenomegaly, findings of bone marrow aspirate and trephine biopsy was noted. Bone marrow trephine biopsy was reviewed for megakaryocytic clustering. Sokal scoring was done; and follow-up data for clinical outcome, i.e complete hematological response (CHR) at 3 months and major molecular response (MMR) at 6 months and 1 year (as per Institute s protocol) was obtained. All the data were analysed using SPSS version 25.\n\n\nRESULTS\nMegakaryocytic clustering was present in 57 (60.6%) patients and absent in 37 (39.4%). In patients with megakaryocytic clustering, CHR was absent in 12 (21.1%), MMR at 6 months was absent in 21 (36.8%) and MMR at 1 year was absent in 25 (43.9%) patients. In patients without megakaryocytic clustering, absent CHR, MMR at 6 months and MMR at 1 year were seen in 1 (2.7%), 2 (5.4%) and 2 (5.4%x), respectively. The correlation of megakaryocytic clustering and high sokal score was found to be statistically significant with a p-value <0.001.\n\n\nCONCLUSION\nPatients with megakaryocytic clustering have poor clinical outcome as indicated by their sokal score, absent CHR, MMR at 6 months and 1 year. Key Words: Chronic myeloid leukaemia, Megakaryocytic clustering, Complete haematological response, Major molecular response, Cytogenetic response.