Services >> Clinical and Laboratory Services >> Leukemia

The Department of hematology has all the facilities necessary for a comprehensive diagnosis of leukemia, including cytochemistry, DNA index, immunophenotyping, cytogenetics, RT-PCR and Fluorescenec insitu hybridization. Today these are necessary since the treatment is dependent on precise diagnosis. Children with acute lymphoblastic leukemia are treated with the German BFM protocol with cure rates of 70%. The Ratan Tata Trust has been providing financial assistance for treatment for a proportion of our patients with leukemia which has considerably eased the financial burden on affected families. The department offers bone marrow transplantation for patients with high risk leukemia who cannot be cured by chemotherapy.

Acute Promyelocytic Leukemia: Treatment of acute promyelocytic leukemia (APL) in the world as been revolutionized by the use of arsenic trioxide since 1997. Our department pioneered the introduction of this therapy in India and we have since been involved in conducting both single and multi-center studies to further improve clinical outcomes. We are also involved in basic science research to study mechanisms of resistance to this drug and evaluating new agents. The work in this field has led to major publications and is internationally recognized.

Chronic Myeloid Leukemia: Imatinib has become the treatment of choice for CML. Our research in this area explores mechanisms of Imatinib mesylate resistance through molecular and cellular biology, pharmacokinetics, pharmacogenetics and epigenetics of the genes involved in transport and biotransformation of these drugs. More than 900 patients are receiving treatment with this agent on a regular basis with the help of an international agency (GIPAP) that provides treatment free of cost.

Acute Myeloid Leukmia: Our current studies focus on 1) Identifying the mechanisms of Cytarabine and Daunorubicin resistance in acute myeloid leukemia; and 2. Evaluating prognostic markers in AML. We are also trying to understand the role of leukemic stem cells in AML and CML on drug resistance:

List of Tests

Qualitative analysis of fusion transcripts by Reverse Transcriptase PCR (RT-PCR) and agarose gel electrophoresis

• p210 BCR-ABL for ALL/CML
• p190 BCR-ABL for ALL/CML
• PML-RARα (bcr 1,2,3) for APML
• TEL-AML1, MLL-AF4, E2A-PBX for ALL
• AML-ETO and inversion 16 for AML
• FIP1L1-PDGFR fusion transcript in hyper eosinophilic syndrome (HES)
• PLZF-RAR for APML

Quantitative analysis of fusion transcripts by quantitative real time PCR (QRT-PCR)

• p210 and P190 BCR-ABL fusion transcripts in CML/ALL
• PML-RARα (bcr1 and bcr3 fusion transcripts) in APML

Bcr-abl kinase domin mutation by RT-PCR and sequencing.

JAK2 analysis by Allele Specific PCR.

NPM1, Exon 12 mutation, FLT3 – ITD and tyrosine kinase domain mutations

Analysis for t(8:14) (cmyc-IgH) translocation in Burkitt’s Lymphoma by DNA-PCR

ELA2 mutation detection for cyclical neutropenia by DNA sequencing.

Exon 8 and Exon 17 c-kit mutation detection for AML/Systemic mastocytosis

Sample requirement/ turn around time