title: [The First Switched Time of PML/RARα Fusion Gene in Patients with Acute Promyelocytic Leukemia and Its Clinical Significance].
abstract: OBJECTIVE
  To investigate the first switched time of PML/RARα fusion gene in patients with acute promyelocytic leukemia (APL) and its clinical significance.
  
  
  METHODS
  sixty cases of newly diagnosed APL were enrolled in this study. They received standard remission induction, consolidation and maintenance treatments according to the clinical pathway for APL, and were followed up. During the same time the PML/RARα fusion gene mRNA expression of all cases was detected by multi-nested PCR.
  
  
  RESULTS
  except for 3 death cases and 1 case failed to follow-up, the PML/RARα fusion genes in the remaining 56 cases were firstly found to be negative from 24 to 381 days respectively, the mean value of the first switched time was 131 ± 90 days. There was no statistically significant difference in age, sex and risk stratification between different groups. However, the cases with L-type PML/RARα gene had shorter time compared with the patients with S-type PML/RARα gene (P = 0.032); then, for the above-mentimed 56 cases, the follow-up duration ranged from 25-1979 days (median 946 days), long-term molecular remissions had been observed in most cases, but 1 case with the first switched time of 133 days unfortunately recurred to be positive and followed by clinical relapse.
  
  
  CONCLUSIONS
  The PML/RARα fusion gene in newly diagnosed APL patients was first switched to be negative in about 4 months after treatment. The first switched time of PML/RARα fusion gene can objectively reflect the reduction of leukemia cells, and the differences among different subtypes of PML/RARα fusion gene may have some suggestions for the treatment, but without important significance for the evaluation of prognosis and recurrence for APL patients. In addition, minimal residual disease (MRD) can be dynamically monitored by detecting PML/RARα fusion gene, thus having an important clinical significance for analysis of APL recurrence.
authors.affiliation: Department of Hematology/Hematological Laboratory, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China.
authors.forename: Lian-Fang
authors.initials: LF
authors.lastname: Pu
authors.affiliation: Department of Hematology/Hematological Laboratory, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China.
authors.forename: Qian-Shan
authors.initials: QS
authors.lastname: Tao
authors.affiliation: Department of Hematology/Hematological Laboratory, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China.
authors.forename: Hui-Ping
authors.initials: HP
authors.lastname: Wang
authors.affiliation: Department of Hematology/Hematological Laboratory, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China. E-mail: zzzm889@163.com.
authors.forename: Zhi-Min
authors.initials: ZM
authors.lastname: Zhai
authors.affiliation: Department of Hematology/Hematological Laboratory, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China. E-mail: xshdao@163.com.
authors.forename: Shu-Dao
authors.initials: SD
authors.lastname: Xiong
mesh_terms: D006801:Humans; D015473:Leukemia, Promyelocytic, Acute; D018365:Neoplasm, Residual; D015514:Oncogene Proteins, Fusion; D016133:Polymerase Chain Reaction; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction
chemical_list: D015514:Oncogene Proteins, Fusion; C093476:promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein