[Clinical significance of detection of PML-RAR alpha fusion gene of APL during differentiation therapy with ATRA].
OBJECTIVE
To characterize of the expression patterns of PML-RAR alpha fusion gene during differentiation therapy with ATRA.


METHODS
A "neated" RT/PCR was established and subsequently used to study on 74 Acute Promyelocytic Leukemia (APL).


RESULTS
Two major isoforms (type S and L) were detected in leukemia cells from 44 novel patients with APL. 19 of 44 (43.2%) patients with type S isoforms were accompanied with poor prognosis. 15 cases were detected sequentially by the RT/PCR method for dynamic observation of MSD during postremission therapy with ATRA and chemotherapy alternatly. The positive rate was 46.7% in 6 months after CR, then the positive rate curve tended to down wards gradually from 33.5% (12 months after CR) to 26.7% (24 months after CR), 11.1% (36 months after CR), 8.3% on 48 months after CR. Other 30 cases of APL which are long-term survivals and received the same postremission program were detected by the RT/PCR method. The expression of the fusion gene reversed positivty in two cases on 56 and 60 months respectively, then both relapsed. One case was detected regularly once a year for 3 times. In another case, the fusion gene was detectable whoever was no any abnormal evidence in peripheral blood and bone marrow 26 cases were negative and had a long-term survival CCR of 47-114 months (medium 66).


CONCLUSIONS
The detection of RT/PCR PML-RAR alpha fusion gene plays an important role in clinical diagnosis, evaluation of prognosis and prediction of relapse in APL.
Institute of Hematology, Reijing Hospital, Shanghai Second Medical University.
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G
Sun
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Zhao
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J
Han
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D003001:Cloning, Molecular; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006248:Harringtonines / Q000008:administration & dosage; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy* / Q000235:genetics*; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage; D008875:Middle Aged; D015514:Oncogene Proteins, Fusion / Q000032:analysis*; D014212:Tretinoin / Q000008:administration & dosage
D006248:Harringtonines; D015514:Oncogene Proteins, Fusion; D003561:Cytarabine; D014212:Tretinoin; D015122:Mercaptopurine