title: Rapid diagnosis of acute promyelocytic leukemia by analyzing the immunocytochemical pattern of the PML protein with the monoclonal antibody PG-M3.
abstract: The fusion protein, promyelocytic leukemia-retinoic acid receptor (PML-RAR)alpha, generated by the t(15;17) translocation has an abnormal cellular distribution with colocalization of RARalpha and PML proteins. We analyzed the immunostaining pattern of PML protein using the PG-M3 monoclonal antibody directed against the amino terminal portion of PML (retained in wild-type PML and PML-RARalpha fusion protein) in the diagnosis of acute promyelocytic leukemia (APL). In addition, we compared this test with other methods for detecting the PML-RARalpha fusion gene. A normal immunostaining pattern was observed in nonmyeloid disorders and in 78 of 111 acute myeloid leukemias (AMLs). A microgranular pattern was observed in 25 AMLs, all corresponding to APL. These results were concordant with the reverse transcriptase-polymerase chain reaction results for PML-RARalpha fusion gene. Only 1 case positive for the PML-RARalpha transcript showed a normal protein pattern by immunocytochemistry. PML immunostaining was helpful to rapidly differentiate 7 cases with borderline characteristics and to obtain the diagnosis in 2 cases with scarce material. The effectiveness and low cost of this technique support its routine use as a first-line procedure in the differential diagnosis of AML.
authors.affiliation: Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Postgraduate School of Hematology Farreras-Valentí, Universitat de Barcelona, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Villamor
authors.forename: D
authors.initials: D
authors.lastname: Costa
authors.forename: M
authors.initials: M
authors.lastname: Aymerich
authors.forename: J
authors.initials: J
authors.lastname: Esteve
authors.forename: A
authors.initials: A
authors.lastname: Carrió
authors.forename: M
authors.initials: M
authors.lastname: Rozman
authors.forename: J L
authors.initials: JL
authors.lastname: Aguilar
authors.forename: B
authors.initials: B
authors.lastname: Falini
authors.forename: E
authors.initials: E
authors.lastname: Montserrat
authors.forename: E
authors.initials: E
authors.lastname: Campo
authors.forename: D
authors.initials: D
authors.lastname: Colomer
mesh_terms: D000911:Antibodies, Monoclonal; D002879:Chromosomes, Human, Pair 10; D002884:Chromosomes, Human, Pair 15; D002886:Chromosomes, Human, Pair 17; D003582:Cytogenetics; D005455:Fluorescent Antibody Technique; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D015473:Leukemia, Promyelocytic, Acute / Q000175:diagnosis* / Q000235:genetics; D009363:Neoplasm Proteins / Q000032:analysis* / Q000235:genetics; D009687:Nuclear Proteins; D015514:Oncogene Proteins, Fusion / Q000032:analysis* / Q000235:genetics; D000071156:Promyelocytic Leukemia Protein; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014157:Transcription Factors / Q000032:analysis; D014178:Translocation, Genetic; D025521:Tumor Suppressor Proteins
chemical_list: D000911:Antibodies, Monoclonal; D009363:Neoplasm Proteins; D009687:Nuclear Proteins; D015514:Oncogene Proteins, Fusion; D000071156:Promyelocytic Leukemia Protein; D014157:Transcription Factors; D025521:Tumor Suppressor Proteins; C093476:promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein; C070576:PML protein, human