Sheth, Frenny JSheth, Jayesh JVerhest, Alain2005-04-142009-06-012005-04-142009-06-012005-04-14Sheth FJ, Sheth JJ, Verhest A. A three way complex translocation (4; 9; 22) in two patients with chronic myelocytic leukemia. Journal of Cancer Research and Therapeutics. 2005 Apr-Jun; 1(2): 108-10http://imsear.searo.who.int/handle/123456789/111532Chronic myeloid leukemia (CML) is genetically characterized by the reciprocal translocation of chromosome 9 and 22, t(9;22)(q34;q11) which results in the fusion of BCR/ABL gene observed on the derivative chromosome 22 called Philadelphia (Ph') chromosome. About 5-8% of Philadelphia positive patients with CML show various complex translocations involving third chromosome in addition to chromosome 9 and 22. In present report we discuss two cases with CML referred at our centre. At the time of initial diagnosis and after 9 months of treatment, one of the patients showed 100% presence of Philadelphia positive in bone marrow culture. During follow-up in an accelerated state, his cytogenetic study revealed a complex translocation (4;9;22)(q25;q34;q11) along with an additional Philadelphia and marker chromosome. The second patient showed a complex (4;9;22)(q25;q34;q11) translocation at the time of diagnosis. He was on hydroxyurea and his follow-up cytogenetic study after the course of chemotherapy showed no changes. Further confirmation of complex translocation was done by FISH study using bcr/abl and whole chromosome 9 probes. Though the additional genes involved in complex variant Ph' rearrangements have not been characterized, both patients are healthy till 3 to 5 years of initial diagnosis. This could be attributed to the benign effect resulted from reciprocal translocation with no loss or gain of the genetic material.engAdultChromosomes, Human, Pair 22Chromosomes, Human, Pair 4Chromosomes, Human, Pair 9HumansIn Situ Hybridization, FluorescenceLeukemia, Myelogenous, Chronic, BCR-ABL Positive --geneticsMaleTranslocation, GeneticCase Reports