Biology of pediatric philadelphia-like acute lymphoblastic leukemia

Biology of Pediatric Philadelphia-like Acute Lymphoblastic Leukemia Philadelphia-like acute lymphoblastic leukemia is a subgroup of B-ALL with high-risk classification and poor prognosis. The gene expression profile is similar to Philadelphia positive acute lymphoblastic leukemia, but this subtype does not have BCR-ABL1 fusion. The disease is genetically heterogeneous. Besides, genetic alterations of Ph-like ALL cases with different ethnic backgrounds differ. It is important that ph-like ALL cases can be classified and differentiated from B-ALL patients to receive effective treatment. In recent years, to identify cases of the Ph-like ALL subgroup, in addition to the evaluation of genetic and clinical findings in B-ALL cases, the design of panels in which gene expression differences are analyzed is on the agenda. For this purpose, to identify the Ph-like group, Ph-positive and Ph negative cases were included in the project among the patients who applied to Bursa Uludağ University Department of Pediatric Hematology. Within the current thesis; This study aimed to establish a gene panel to be used to identify Ph-like ALL cases specific to the Turkish population. After RNA isolation with 23 bone marrow materials, mRNA gene expression profiles were analyzed by RT-qPCR method. In the custom mRNA gene panel prepared within the study, 96 genes were evaluated and 36 genes with a similar expression as the control group could be a biomarker panel may be used to identify cases of Ph-like ALL. In the present study, a pre-differential diagnosis was made by determining the gene profiles of the Ph-like subgroup among the pediatric B-ALL patients. As a result of advanced analysis; By adding targeted tyrosine kinase inhibitors to the treatment protocols of the Ph-like ALL subgroup defined by the gene panel of the Turkish population, it will contribute to improve the prognosis and increase survival rates. Keywords: Philadelphia-like, Acute Lymphoblastic Leukemia, Pediatric, Gene Expression, RT-qPCR