FREQUENCY OF NRAS AND KRAS GENES IN NEWLY DIAGNOSED ACUTE MYELOID LEUKEMIA PATIENTS

Abstract

Objective: To determine the frequency of NRAS and KRAS mutations in newly diagnosed acute myeloid leukemia patients and correlation with their clinicopathological parameters along with prognostic impact.

Study Design: Cross-sectional study.

Place and Duration of Study: Armed Forces Institute of Haematology, Rawalpindi, from Mar 2017 to Aug 2017.

Methodology: A total of 70 acute myeloid leukemia patients were recruited in this study. Each patient was assessed by blood complete picture, bone marrow examination (aspiration and trephine biopsy) and cytochemical staining by sudan black. Flow cytometry was done for immunophenotyping of each patient. Mutation analysis of NRAS and KRAS of exon 1 and exon 2 were performed on Peripheral /bone marrow sample by PCR followed by purification and analysis of gene mutations by Sanger sequencing.

Results: Of the seventy patients, five percent were positive for NRAS mutation while no KRAS Mutation was detected in our study. Mean age of our patients was 31.5 with a SD of ± 18.9. Patients presented very high levels of WBC with an average of 83.7 ± 107 years. Regarding clinicopathological parameters all NRAS mutation positive patients and NRAS mutation negative patients there was prominent splenomegaly as well as bleeding from gums but the percentage of splenomegaly and bleeding gums was much greater in NRAS mutation patients as compared to NRAS negative patients.

Conclusion: There were limited studies regarding NRAS and KRAS mutations in Pakistan so larger sample size is required to determine frequency along with its prognostic impact.