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Clinical Chemistry 48: 1858-1860, 2002;
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(Clinical Chemistry. 2002;48:1858-1860.)
© 2002 American Association for Clinical Chemistry, Inc.

Abstracts of Oak Ridge Posters

Molecular Monitoring of Acute Promyelocytic Leukemia by DzyNA Reverse Transcription-PCR

Tanya L. Applegate1a, Harry J. Iland2, Elisa Mokany1 and Alison V. Todd1

1 Johnson & Johnson Research Pty Limited, Australian Technology Park, Eveleigh NSW 1430, Australia

2 Kanematsu Laboratories, Royal Prince Alfred Hospital, Camperdown, Sydney NSW 2050, Australia

aaddress correspondence to this author at: Biomedical Bldg., Level 4, 1 Central Ave., Australian Technology Park, Eveleigh NSW 1430, Australia; fax 61-2-83965811, e-mail tapplega@medau.jnj.com

The first 300 words of the full text of this article appear below.

Acute promyelocytic leukemia (APL) is caused by inhibition of apoptosis and a block in myeloid differentiation resulting from a translocation invariably involving the retinoic acid {alpha} (RAR{alpha}) gene (1)(2). Ninety percent of breakpoints lie within intron 3 or 6 of the PML gene, producing fusion transcripts of the S-type (exon 3 PML/exon 3 RAR{alpha}) or L-type (exon 6 PML/exon 3 RAR{alpha}) isoform. The remaining patients have V-type transcripts, which vary in length depending on where the breakpoint lies within exon 6 of the PML gene. Although a combination of all-trans-retinoic acid (ATRA) differentiation therapy and chemotherapy successfully induces remission in the majority of patients harboring the PML/RAR{alpha} transcript, approximately one-third of these patients relapse (3). Patient survival rates are improved by initiating salvage therapy at molecular relapse rather than waiting for overt hematologic relapse (4)(5). Recent preliminary results suggest that the predictive power of molecular monitoring may be improved by the application of new quantitative methods to patient management (6)(7). This report provides the most recent patient results obtained with the single-tube DzyNA reverse transcription-PCR (RT-PCR) assay recently developed in our laboratory for diagnosing and monitoring APL (8).

DzyNA RT-PCR assays for quantification of PML/RAR{alpha} transcripts and endogenous BCR control transcripts were used to analyze total RNA from patients with APL. Specimens were analyzed with the investigator blinded to the patients’ clinical histories. Primers, substrate, and reaction conditions for DzyNA RT-PCR and confirmatory two-step nested qualitative RT-PCR were as described previously (8). The PML/RAR{alpha} primers amplify all L-type, and most V-type, transcripts. PML/RAR{alpha} concentrations were normalized by use of BCR concentrations, thus controlling for variations in RNA integrity from clinical specimens. Quantitative data were expressed as . . . [Full Text of this Article]






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