Evaluation of the detection of PML-RARα fusion gene in acute promyelocytic leukemia to monitor minimal residual disease

Objective To investigate the kinetics of PML-RARα fusion gene in acute promyelocytic leukemia(APL)to monitor minimal residual disease(MRD). Methods In induction therapy,consolidation and maintenance therapy courses, PML-RARα fusion gene was performed by RT-PCR. Results The long-term follow-up of 18 cases achieved complete remission (CR),two cases experienced molecular relapse. One case relapsed at 4 months after CR1 and achieved CR2 after induction therapy. However, molecular and hematology relapsed again at 2 months after CR2 and re-achieved CR3. The other case relapsed at 74 months after CR1 and achieved CR2 after induction treatment, who had survived for 106 months until the end of follow-up. Conclusion RT-PCR assay for detection of PML-RARα should be performed regularly during CR period so as to find molecular relapse eady. Hematological relapse could potentially be averted through treatment modification according to molecular monitoring results of PML-RARα.     

Evaluation of the detection of PML-RARα fusion gene in acute promyelocytic leukemia to monitor minimal residual disease

Objective To investigate the kinetics of PML-RARα fusion gene in acute promyelocytic leukemia(APL)to monitor minimal residual disease(MRD). Methods In induction therapy,consolidation and maintenance therapy courses, PML-RARα fusion gene was performed by RT-PCR. Results The long-term follow-up of 18 cases achieved complete remission (CR),two cases experienced molecular relapse. One case relapsed at 4 months after CR1 and achieved CR2 after induction therapy. However, molecular and hematology relapsed again at 2 months after CR2 and re-achieved CR3. The other case relapsed at 74 months after CR1 and achieved CR2 after induction treatment, who had survived for 106 months until the end of follow-up. Conclusion RT-PCR assay for detection of PML-RARα should be performed regularly during CR period so as to find molecular relapse eady. Hematological relapse could potentially be averted through treatment modification according to molecular monitoring results of PML-RARα.     

Evaluation of the detection of PML-RARα fusion gene in acute promyelocytic leukemia to monitor minimal residual disease

Objective To investigate the kinetics of PML-RARα fusion gene in acute promyelocytic leukemia(APL)to monitor minimal residual disease(MRD). Methods In induction therapy,consolidation and maintenance therapy courses, PML-RARα fusion gene was performed by RT-PCR. Results The long-term follow-up of 18 cases achieved complete remission (CR),two cases experienced molecular relapse. One case relapsed at 4 months after CR1 and achieved CR2 after induction therapy. However, molecular and hematology relapsed again at 2 months after CR2 and re-achieved CR3. The other case relapsed at 74 months after CR1 and achieved CR2 after induction treatment, who had survived for 106 months until the end of follow-up. Conclusion RT-PCR assay for detection of PML-RARα should be performed regularly during CR period so as to find molecular relapse eady. Hematological relapse could potentially be averted through treatment modification according to molecular monitoring results of PML-RARα.     

Evaluation of the detection of PML-RARα fusion gene in acute promyelocytic leukemia to monitor minimal residual disease

Objective To investigate the kinetics of PML-RARα fusion gene in acute promyelocytic leukemia(APL)to monitor minimal residual disease(MRD). Methods In induction therapy,consolidation and maintenance therapy courses, PML-RARα fusion gene was performed by RT-PCR. Results The long-term follow-up of 18 cases achieved complete remission (CR),two cases experienced molecular relapse. One case relapsed at 4 months after CR1 and achieved CR2 after induction therapy. However, molecular and hematology relapsed again at 2 months after CR2 and re-achieved CR3. The other case relapsed at 74 months after CR1 and achieved CR2 after induction treatment, who had survived for 106 months until the end of follow-up. Conclusion RT-PCR assay for detection of PML-RARα should be performed regularly during CR period so as to find molecular relapse eady. Hematological relapse could potentially be averted through treatment modification according to molecular monitoring results of PML-RARα.     

Evaluation of the detection of PML-RARα fusion gene in acute promyelocytic leukemia to monitor minimal residual disease

Objective To investigate the kinetics of PML-RARα fusion gene in acute promyelocytic leukemia(APL)to monitor minimal residual disease(MRD). Methods In induction therapy,consolidation and maintenance therapy courses, PML-RARα fusion gene was performed by RT-PCR. Results The long-term follow-up of 18 cases achieved complete remission (CR),two cases experienced molecular relapse. One case relapsed at 4 months after CR1 and achieved CR2 after induction therapy. However, molecular and hematology relapsed again at 2 months after CR2 and re-achieved CR3. The other case relapsed at 74 months after CR1 and achieved CR2 after induction treatment, who had survived for 106 months until the end of follow-up. Conclusion RT-PCR assay for detection of PML-RARα should be performed regularly during CR period so as to find molecular relapse eady. Hematological relapse could potentially be averted through treatment modification according to molecular monitoring results of PML-RARα.     

Evaluation of the detection of PML-RARα fusion gene in acute promyelocytic leukemia to monitor minimal residual disease

Objective To investigate the kinetics of PML-RARα fusion gene in acute promyelocytic leukemia(APL)to monitor minimal residual disease(MRD). Methods In induction therapy,consolidation and maintenance therapy courses, PML-RARα fusion gene was performed by RT-PCR. Results The long-term follow-up of 18 cases achieved complete remission (CR),two cases experienced molecular relapse. One case relapsed at 4 months after CR1 and achieved CR2 after induction therapy. However, molecular and hematology relapsed again at 2 months after CR2 and re-achieved CR3. The other case relapsed at 74 months after CR1 and achieved CR2 after induction treatment, who had survived for 106 months until the end of follow-up. Conclusion RT-PCR assay for detection of PML-RARα should be performed regularly during CR period so as to find molecular relapse eady. Hematological relapse could potentially be averted through treatment modification according to molecular monitoring results of PML-RARα.     

Evaluation of the detection of PML-RARα fusion gene in acute promyelocytic leukemia to monitor minimal residual disease

Objective To investigate the kinetics of PML-RARα fusion gene in acute promyelocytic leukemia(APL)to monitor minimal residual disease(MRD). Methods In induction therapy,consolidation and maintenance therapy courses, PML-RARα fusion gene was performed by RT-PCR. Results The long-term follow-up of 18 cases achieved complete remission (CR),two cases experienced molecular relapse. One case relapsed at 4 months after CR1 and achieved CR2 after induction therapy. However, molecular and hematology relapsed again at 2 months after CR2 and re-achieved CR3. The other case relapsed at 74 months after CR1 and achieved CR2 after induction treatment, who had survived for 106 months until the end of follow-up. Conclusion RT-PCR assay for detection of PML-RARα should be performed regularly during CR period so as to find molecular relapse eady. Hematological relapse could potentially be averted through treatment modification according to molecular monitoring results of PML-RARα.     

Evaluation of the detection of PML-RARα fusion gene in acute promyelocytic leukemia to monitor minimal residual disease

Objective To investigate the kinetics of PML-RARα fusion gene in acute promyelocytic leukemia(APL)to monitor minimal residual disease(MRD). Methods In induction therapy,consolidation and maintenance therapy courses, PML-RARα fusion gene was performed by RT-PCR. Results The long-term follow-up of 18 cases achieved complete remission (CR),two cases experienced molecular relapse. One case relapsed at 4 months after CR1 and achieved CR2 after induction therapy. However, molecular and hematology relapsed again at 2 months after CR2 and re-achieved CR3. The other case relapsed at 74 months after CR1 and achieved CR2 after induction treatment, who had survived for 106 months until the end of follow-up. Conclusion RT-PCR assay for detection of PML-RARα should be performed regularly during CR period so as to find molecular relapse eady. Hematological relapse could potentially be averted through treatment modification according to molecular monitoring results of PML-RARα.     

PML-RARα融合基因监测急性早幼粒细胞白血病微小残留病

 目的　观察PML-RARα融合基因在监测急性早幼粒细胞白血病（APL）微小残留病（MRD）中的临床意义。方法　诱导缓解及巩固维持治疗期间,采用筑巢式反转录-聚合酶链反应（RT-PCR）技术检测患者骨髓细胞中PML-RARα融合基因的动态变化、PML-RARα融合基因。结果　长期随访的18例完全缓解（CR）患者,2例出现分子学复发。其中1例发生于CR1后4个月,诱导缓解治疗后获得CR2,CR2后2个月再次出现分子学与血液学的复发,诱导治疗1个疗程获得CR3;1例发生于CR1后74个月,诱导缓解治疗后获得CR2,随访结束时生存期已达106个月。结论　在CR期定期监测PML-RARα融合基因,可早期发现分子学复发,及时干预治疗可避免血液学复发。     

PML-RARα和NPM-RARα融合基因双阳性急性早幼粒细胞白血病一例并文献复习

目的:探讨PML-RARα和NPM-RARα融合基因双阳性急性早幼粒细胞白血病（APL）的诊疗及预后。方法:回顾性分析2019年3月上海健康医学院附属嘉定区中心医院收治的1例PML-RARα和NPM-RARα融合基因双阳性APL患者的形态学、免疫学、细胞遗传学、分子生物学、治疗、随访等资料,并复习相关文献。结果:患者,男性,57岁。血常规示全血细胞减少;骨髓形态学检查示异常早幼粒细胞占0.695;免疫分型检测示CD13、CD33、CD64、CD117阳性,CD3、CD4、CD14、CD19、CD34、CD56、HLA-DR阴性;染色体核型为46,XY,t（15; 17）（q24; q21）[17]/46,XY[6];荧光原位杂交（FISH）检测到PML-RARα融合基因;融合基因检测示PML-RARα-S、NPM-RARα融合基因均阳性。患者经全反式维甲酸（ATRA）、三氧化二砷（ATO）、伊达比星诱导治疗以及ATRA、伊达比星巩固治疗后达分子学完全缓解,随访1年无复发。结论:PML-RARα和NPM-RARα融合基因双阳性APL临床罕见,可采用ATRA、ATO联合化疗方案,疗效尚可,但其预后可能不如单纯PML-RARα融合基因阳性的患者。     

急性早幼粒细胞白血病两种PML-RARα融合基因亚型的临床研究

 目的　探讨急性早幼粒细胞白血病（APL）PML-RARα融合基因亚型及其临床关系。方法　采用巢式反转录聚合酶链反应（RT-PCR）检测92例初诊APL患者PML-RARα融合基因不同转录本,根据结果分为长型（L型）和短型（S型）两组,比较两组间的临床特征、治疗反应及预后。结果　92例APL患者PML- RARα融合基因均为阳性,L型52例,占56.5 %,S型40例,占43.5 %;两组相比,患者性别、年龄、治疗前的白细胞计数、骨髓原始早幼粒细胞比例及染色体无明显差异;诱导治疗的完全缓解（CR）率、达CR的时间、维甲酸综合征（RAS）、弥漫性血管内凝血（DIC）、颅内出血的发生差异无统计学意义;两组缓解后总体生存率（OS）及无复发生存率（RFS）亦差异无统计学意义。结论　APL患者PML-RARα融合基因亚型与临床疗效、预后无关。     

染色体分析及FISH法对急性早幼粒细胞白血病诊断的临床意义

目的探讨染色体分析及FISH检测对急性早幼粒细胞白血病（APL）诊断的临床意义。方法骨髓标本经细胞培养后,采用染色体G带显带方法分析是否存在t（15;17）,同时用FISH方法进行与t（15;17）相关的PML-RARα融合基因的检测。结果38例确诊APL的患者中,病理形态学检出率为92.1%（36/38）,染色体分析36例发现克隆性t（15;17）存在,检出率为92.1%;FISH检测发现所有病例均存在PML-RARα融合基因,检出率为100.0%。结论染色体分析及FISH检测t（15;17）相关的PML-RARα融合基因是诊断APL的可靠指标;其中FISH检测更为敏感。     

早幼粒白血病-维甲酸受体α融合蛋白对RIAM基因转录的负调控作用探讨

目的:研究异常转录因子早幼粒白血病-维甲酸受体α(promyelocytic leukemia-retinoic acid receptor alpha,PML-RARα)融合蛋白对RIAM基因的转录调控机制.方法:利用表达谱数据库(GSE1159)比较RIAM基因在急性髓系白血病(acute myeloid leukemia,AML)各亚型中的表达情况,以及RIAM基因和PML-RARα融合蛋白之间的相关性.采用蛋白质印迹法和实时荧光定量-PCR法分别检测PML-RARα融合蛋白和RIAM基因在急性早幼粒细胞白血病(acute promyelocytic leukemia,APL)模式细胞株PR9及APL患者来源的细胞株NB4中的表达情况,以及在全反式维甲酸(all-trans retinoic acid,ATRA)处理前后的RIAM mRNA的表达情况.利用染色质免疫沉淀技术检测细胞内PML-RARα融合蛋白在RIAM基因启动子附近的结合情况.结果:RIAM基因在APL(即M3型AML)中的表达水平明显低于其他AML亚型(M0、M1、M2、M4、M5和M7型)和正常造血细胞(P＜0.05).随着PML-RARα融合蛋白的表达,RIAM基因的表达水平明显降低.ATRA能激活RIAM基因的表达,且PML-RARα融合蛋白的表达能增强ATRA对RIAM基因表达的激活效应.PML-RARα融合蛋白结合在RIAM基因的启动子区域.结论:RIAM基因是PML-RARα融合蛋白的靶基因,PML-RARα融合蛋白通过结合到RIAM基因的启动子区域对其转录进行负调控.