Prognostically Significant Fusion Oncogenes and Gene Mutations in Pakistani AML Patients

Background: The onset and progression of leukemia is associated with many genetic abnormalities including gene mutations and production of fusion oncogenes. Molecular studies on fusion oncogenes and mutations in different populations have been done. However, not much research on correlation of the fusion oncogenes with acute myeloid leukemia have been done in Pakistan.Methods: Genetic analysis of 105 AML patients was done to investigate AML1-ETOand CBFB-MYH11 fusion oncogenes and mutations in NPM1 and NRAS genes. The genomic DNA and cDNA were subjected to amplification, electrophoresis, and Sanger sequencing.Results: The frequency of AML1-ETO was 26% in AML patients and 34.2% in AML-M2 patients. CBFB-MYH11 was present in 11.4% AML patients. A total of six mutations in 4 regions of NPM1 gene and 2 regions of NRAS gene were detected. 3’UTR of NPMI gene had three variants; g.1128C>T (57.1%), g.1185-/T insertion (80.95%), and g.1163A>T (57.14%) while c.867_871subGTGGA >CAAGTTTGC (2.86%) was present in exon 12. NRAS gene had two mutations c.12C>T (51.4%) and c.33A>T (11.43%) in exon 2. c.867_871subGTGGA >CAAGTTTGC , and g.1163A>T in NPM1 gene and c.33A>T in NRAS gene were the novel findings in this ethnic population.Conclusion: This genetic analysis may help to modulate the treatment strategies and improve survival of patients.