title: Cytogenetics, FISH and RT-PCR analysis of acute promyelocytic leukemia: structure of the fusion point in a case lacking classic t(15;17) translocation.
abstract: The chimeric gene product PML-RAR alpha, the result of a reciprocal t(15;17) translocation, plays an important role in the pathogenesis of acute promyelocytic leukemia (APL). In the present study on clinical effects of cytogenetics and molecular events in APL, we performed chromosome analysis, fluorescence in situ hybridization (FISH) using gene-specific probe, and reverse transcription-polymerase chain reaction (RT-PCR) analysis in 10 patients with APL. Patients were treated with all-trans retinoic acid (ATRA) and/or chemotherapy, and all achieved complete remission. Cytogenetic analysis revealed the classic translocation t(15;17) in nine of 10 patients, and a remaining patient had an apparently normal karyotype. Interphase FISH was performed in nine patients, and revealed the presence of PML-RAR alpha fusion gene in all patients. RT-PCR analysis in 10 patients showed that eight expressed long (L)-form type, one expressed a short (S)-form type, and the other expressed a variable (V)-form type. Metaphase FISH of the patient with normal karyotype revealed a juxtaposed PML-RAR alpha fusion signal on one chromosome 17 homologue, an RAR alpha signal on the other chromosome 17 homologue, and one PML signal on each chromosome 15 homologue. Moreover, V-form of the PML-RAR alpha transcript was detected, and a portion of RAR alpha intron 2 was found inserted in the breakpoint region. ATRA differentiation induction therapy was effective in treating this patient, a result infrequently reported in cytogenetic and molecular investigations of APL.
authors.affiliation: Blood Center, Showa University, Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama 227-8501, Japan. fujitak@cmed.showa-u.ac.jp
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Fujita
authors.forename: Remi
authors.initials: R
authors.lastname: Oba
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Harada
authors.forename: Hiraku
authors.initials: H
authors.lastname: Mori
authors.forename: Haruo
authors.initials: H
authors.lastname: Niikura
authors.forename: Keiichi
authors.initials: K
authors.lastname: Isoyama
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Omine
mesh_terms: D000293:Adolescent; D000328:Adult; D002884:Chromosomes, Human, Pair 15; D002886:Chromosomes, Human, Pair 17; D020732:Cytogenetic Analysis; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007438:Introns; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000235:genetics; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D012333:RNA, Messenger; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D014178:Translocation, Genetic; D014212:Tretinoin / Q000627:therapeutic use
chemical_list: D009363:Neoplasm Proteins; D015514:Oncogene Proteins, Fusion; D012333:RNA, Messenger; C093476:promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein; D014212:Tretinoin