title: Utility and impact of early t(15;17) identification by Fluorescence In Situ Hybridization (FISH) in clinical decision making for patients in Acute Promyelocytic Leukemia (APL).
abstract: BACKGROUND
  Acute Promyelocytic Leukemia (APL) is a curable malignancy with studies showing above 90% survival. However, population-based studies looking at survival suggest that approximately 30% of patients with APL die during induction. Early demonstration of t(15;17) will lead to accurate decision making regarding treatment. The aim of this project was to validate earlier time frames for the Abbott Molecular Vysis LSI promyelocytic leukemia (PML)/ retinoic acid receptor alpha (RARA) fluorescence in situ hybridization (FISH) probe (ASR 6-16 h).
  
  
  METHODS
  Twenty patients (15 APL cases and five non-APL cases) were selected for validating various hybridization times for the FISH probe. Expected normal signal pattern was two red and two green signals (2R2G), and the most common expected abnormal signal pattern was two fusion (yellow) signals, one red and one green (2F1R1G) and/or one fusion, one red and one green (1F1R1G).
  
  
  RESULTS
  The specificity of the probe ranged from 84% at 2 h, 86% at 4 h, 84% at 6 h, and 87% for overnight hybridization. The sensitivity increased from 79% at 2 h, 80% at 4 h, 81% at 6 h to 87% for overnight hybridization.
  
  
  CONCLUSIONS
  Based on the validation studies, we recommend reading of FISH results at the 4-h incubation mark for a preliminary diagnosis and confirmation with overnight hybridization.
authors: Department of Pathology, Georgia Regents University, Augusta, GA, USA.
authors: R
authors: http://orcid.org/0000-0002-8283-2403
authors: R
authors: Kolhe
authors: Department of Internal Medicine, Georgia Regents University Cancer Center, Augusta, GA, USA.
authors: A
authors: A
authors: Mangaonkar
authors: Department of Internal Medicine, Georgia Regents University Cancer Center, Augusta, GA, USA.
authors: J
authors: J
authors: Mansour
authors: University of Georgia College of Pharmacy, Augusta, GA, USA.
authors: A
authors: A
authors: Clemmons
authors: Department of Pathology, Georgia Regents University, Augusta, GA, USA.
authors: J
authors: J
authors: Shaw
authors: Department of Pathology, Georgia Regents University, Augusta, GA, USA.
authors: B
authors: B
authors: Dupont
authors: Department of Pathology, Georgia Regents University, Augusta, GA, USA.
authors: L
authors: L
authors: Walczak
authors: Department of Pathology, Georgia Regents University, Augusta, GA, USA.
authors: A
authors: A
authors: Mondal
authors: Department of Pathology, Georgia Regents University, Augusta, GA, USA.
authors: A
authors: A
authors: Rojiani
authors: Winship Cancer Institute of Emory University, Atlanta, GA, USA.
authors: A
authors: A
authors: Jillella
authors: Winship Cancer Institute of Emory University, Atlanta, GA, USA.
authors: V
authors: V
authors: Kota
mesh_terms: D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology; D016022:Case-Control Studies; D002884:Chromosomes, Human, Pair 15; D002886:Chromosomes, Human, Pair 17; D000066491:Clinical Decision-Making; D042241:Early Diagnosis; D015870:Gene Expression; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D015473:Leukemia, Promyelocytic, Acute / Q000175:diagnosis* / Q000235:genetics* / Q000473:pathology; D007963:Leukocytes, Mononuclear / Q000378:metabolism / Q000473:pathology; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology; D018168:Receptors, Retinoic Acid / Q000235:genetics*; D000072482:Retinoic Acid Receptor alpha; D012680:Sensitivity and Specificity; D013997:Time Factors; D014178:Translocation, Genetic
chemical_list: C000607071:RARA protein, human; D018168:Receptors, Retinoic Acid; D000072482:Retinoic Acid Receptor alpha
keywords: Acute promyelocytic leukemia; Fluorescence In Situ Hybridization; early diagnosis