1
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Chen Z. The e1a3 BCR-ABL1 fusion transcript in Philadelphia chromosome-positive acute lymphoblastic leukaemia: a case report. Hematology 2023; 28:2186040. [PMID: 36912524 DOI: 10.1080/16078454.2023.2186040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
ABSTRACTThe Philadelphia (Ph) chromosome results from the formation of breakpoint cluster region (BCR)-Abelson 1 (ABL1) fusion gene (BCR-ABL1). The most common type of adult acute lymphoblastic leukaemia (ALL) is Ph chromosome-positive (Ph+); Ph+ ALL has an incidence of 25%∼30%. Several types of BCR-ABL1 fusion transcripts have been reported, including e1a2, e13a2 and e14a2. In addition, some rare BCR-ABL1 transcripts, such as e1a3, have been reported in chronic myeloid leukaemia. However, until now, the presence of e1a3 BCR-ABL1 fusion transcripts has only been reported in a few cases of ALL. In this study, a rare e1a3 BCR-ABL1 fusion transcript was found in a patient diagnosed with Ph+ ALL. However, the patient also suffered from severe agranulocytosis with pulmonary infection and died after being transferred to the intensive care unit before the significance of the presence of e1a3 BCR-ABL1 fusion transcript could be determined. In conclusion, e1a3 BCR-ABL1 fusion transcripts related to Ph+ ALL cases need to be better identified, and appropriate treatment strategies must be designed for such cases.
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Affiliation(s)
- Ziang Chen
- Department of Hematology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, People's Republic of China
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2
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Burmeister T, Bullinger L, le Coutre P. The Recurrent Atypical e8a2 BCR::ABL1 Transcript with Insertion of an Inverted 55 Base Pair ABL1 Intron 1b Sequence: A Detailed Molecular Analysis. Acta Haematol 2023; 146:413-418. [PMID: 37231781 DOI: 10.1159/000531128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023]
Abstract
Atypical BCR::ABL1 transcripts are found in approximately 2% of cases of chronic myeloid leukemia. It is important to detect them since affected patients also benefit from tyrosine kinase inhibitor therapy. In the rare e8a2 atypical BCR::ABL1 transcript, two out-of-frame exons are fused, thus, interposed nucleotides are usually found at the fusion site to restore the reading frame. In approximately half of previously reported e8a2 BCR::ABL1 cases, an inserted 55 bp sequence homologous to an inverted sequence from ABL1 intron 1b was detected. The generation of this recurrent transcript variant is not obvious. This work describes the molecular analysis of such an e8a2 BCR::ABL1 translocation from a CML patient. The genomic chromosomal breakpoint is identified, and the formation of this transcript is theoretically explained. The clinical course of the patient is reported, and recommendations are provided for the molecular analysis of future e8a2 BCR::ABL1 cases.
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MESH Headings
- Humans
- Fusion Proteins, bcr-abl/genetics
- Introns
- Base Pairing
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Sequence Inversion
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Affiliation(s)
- Thomas Burmeister
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow, Medizinische Klinik für Hämatologie, Onkologie und Tumorimmunologie, Berlin, Germany
- Labor Berlin Charité - Vivantes, Berlin, Germany
| | - Lars Bullinger
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow, Medizinische Klinik für Hämatologie, Onkologie und Tumorimmunologie, Berlin, Germany
| | - Philipp le Coutre
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Mitte, Medizinische Klinik für Hämatologie, Onkologie und Tumorimmunologie, Berlin, Germany
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3
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Mroczkowska A, Jaźwiec B, Urbańska-Rakus J, Szymanowska S, Tessmann A, Pająk S, Machnik K, Haus O, Wróbel T. A case report of pediatric acute lymphoblastic leukemia with e8a2 BCR/ABL1 fusion transcript. BMC Med Genomics 2022; 15:20. [PMID: 35123463 PMCID: PMC8818218 DOI: 10.1186/s12920-022-01169-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 01/27/2022] [Indexed: 11/21/2022] Open
Abstract
Background Acute lymphoblastic leukemia is the most common type of cancer in children. Most often it affects the age group between 2 and 5 years of age. Studies have shown an improvement in general survivability, more than 90% 5-year overall survival (OS). Current treatment protocols for acute lymphoblastic leukemia require verification of the presence of favorable and unfavorable genetic abnormalities, which help qualify patients to the appropriate risk group and select a more suitable treatment. The presence of the BCR/ABL1 fusion gene stratifies the patient into a high-risk group and requires special treatment with tyrosine kinase inhibitors (TKI). The three dominant mRNA transcripts are e1a2, e13a2, and e14a2. Nevertheless, cases of atypical BCR/ABL1 transcripts have also been reported. Case presentation This paper presents the case of a pediatric patient with Ph + B-cell precursor acute lymphoblastic leukemia with rare atypical e8a2 BCR/ABL1 fusion transcript. Our patient achieved complete remission after 33 days of treatment. Molecular and cytogenetic studies in TP1 did not reveal the presence of the BCR/ABL1 transcript. The PCR-MRD test in TP1b was negative, the patient did not require hematopoietic stem cell transplantation. Conclusion Genetic evaluation of the bone marrow sample is crucial in the initial stage of the diagnosis. Fluorescent in situ hybridization and reverse transcriptase polymerase chain reaction with Sanger sequencing are the appropriate methods used in the detection of rare variants of BCR/ABL1 transcripts.
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Osman AEG, Deininger MW. Chronic Myeloid Leukemia: Modern therapies, current challenges and future directions. Blood Rev 2021; 49:100825. [PMID: 33773846 DOI: 10.1016/j.blre.2021.100825] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/22/2021] [Accepted: 03/14/2021] [Indexed: 12/12/2022]
Abstract
Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm caused by a reciprocal translocation [t(9;22)(q34;q11.2)] that leads to the fusion of ABL1 gene sequences (9q34) downstream of BCR gene sequences (22q11) and is cytogenetically visible as Philadelphia chromosome (Ph). The resulting BCR/ABL1 chimeric protein is a constitutively active tyrosine kinase that activates multiple signaling pathways, which collectively lead to malignant transformation. During the early (chronic) phase of CML (CP-CML), the myeloid cell compartment is expanded, but differentiation is maintained. Without effective therapy, CP-CML invariably progresses to blast phase (BP-CML), an acute leukemia of myeloid or lymphoid phenotype. The development of BCR-AB1 tyrosine kinase inhibitors (TKIs) revolutionized the treatment of CML and ignited the start of a new era in oncology. With three generations of BCR/ABL1 TKIs approved today, the majority of CML patients enjoy long term remissions and near normal life expectancy. However, only a minority of patients maintain remission after TKI discontinuation, a status termed treatment free remission (TFR). Unfortunately, 5-10% of patients fail TKIs due to resistance and are at risk of progression to BP-CML, which is curable only with hematopoietic stem cell transplantation. Overcoming TKI resistance, improving the prognosis of BP-CML and improving the rates of TFR are areas of active research in CML.
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Affiliation(s)
- Afaf E G Osman
- Division of Hematology & Hematologic Malignancies, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
| | - Michael W Deininger
- Division of Hematology & Hematologic Malignancies, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
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Suttorp M, Millot F, Sembill S, Deutsch H, Metzler M. Definition, Epidemiology, Pathophysiology, and Essential Criteria for Diagnosis of Pediatric Chronic Myeloid Leukemia. Cancers (Basel) 2021; 13:cancers13040798. [PMID: 33672937 PMCID: PMC7917817 DOI: 10.3390/cancers13040798] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/04/2021] [Accepted: 02/08/2021] [Indexed: 02/07/2023] Open
Abstract
Simple Summary The low incidence (1:1,000,000) of chronic myeloid leukemia (CML) in the first two decades of life presents an obstacle to accumulation of pediatric experience and knowledge on this leukemia. Biological features of CML are shared but also differing between adult and pediatric patients. This review aims; (i) to define the disease based on an unified terminology, (ii) to list the diseases to be considered as a differential diagnosis in children, (iii) to outlines the morphological, histopathological and immuno-phenotypical findings of pediatric CML, (iv) to illustrate rare but classical complications resulting from high white cell and platelet counts at diagnosis, and (v) to recommend a uniform approach for the diagnostic procedures to be applied. Evidently, only a clear detailed picture of all relevant features can lay the basis for standardized treatment approaches. Abstract Depending on the analytical tool applied, the hallmarks of chronic myeloid leukemia (CML) are the Philadelphia Chromosome and the resulting mRNA fusion transcript BCR-ABL1. With an incidence of 1 per 1 million of children this malignancy is very rare in the first 20 years of life. This article aims to; (i) define the disease based on the WHO nomenclature, the appropriate ICD 11 code and to unify the terminology, (ii) delineate features of epidemiology, etiology, and pathophysiology that are shared, but also differing between adult and pediatric patients with CML, (iii) give a short summary on the diseases to be considered as a differential diagnosis of pediatric CML, (iv) to describe the morphological, histopathological and immunophenotypical findings of CML in pediatric patients, (v) illustrate rare but classical complications resulting from rheological problems observed at diagnosis, (vi) list essential and desirable diagnostic criteria, which hopefully in the future will help to unify the attempts when approaching this rare pediatric malignancy.
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Affiliation(s)
- Meinolf Suttorp
- Pediatric Hemato-Oncology, Medical Faculty, Technical University Dresden, D-01307 Dresden, Germany
- Correspondence: ; Tel.: +49-351-458-3522; Fax: +49-351-458-5864
| | - Frédéric Millot
- Inserm CIC 1402, University Hospital Poitiers, F-86000 Poitiers, France; (F.M.); (H.D.)
| | - Stephanie Sembill
- Pediatric Oncology and Hematology, Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, D-91504 Erlangen, Germany; (S.S.); (M.M.)
| | - Hélène Deutsch
- Inserm CIC 1402, University Hospital Poitiers, F-86000 Poitiers, France; (F.M.); (H.D.)
| | - Markus Metzler
- Pediatric Oncology and Hematology, Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, D-91504 Erlangen, Germany; (S.S.); (M.M.)
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6
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Neckles C, Sundara Rajan S, Caplen NJ. Fusion transcripts: Unexploited vulnerabilities in cancer? WILEY INTERDISCIPLINARY REVIEWS-RNA 2019; 11:e1562. [PMID: 31407506 PMCID: PMC6916338 DOI: 10.1002/wrna.1562] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/05/2019] [Accepted: 07/08/2019] [Indexed: 12/12/2022]
Abstract
Gene fusions are an important class of mutations in several cancer types and include genomic rearrangements that fuse regulatory or coding elements from two different genes. Analysis of the genetics of cancers harboring fusion oncogenes and the proteins they encode have enhanced cancer diagnosis and in some cases patient treatment. However, the effect of the complex structure of fusion genes on the biogenesis of the resulting chimeric transcripts they express is not well studied. There are two potential RNA‐related vulnerabilities inherent to fusion‐driven cancers: (a) the processing of the fusion precursor messenger RNA (pre‐mRNA) to the mature mRNA and (b) the mature mRNA. In this study, we discuss the effects that the genetic organization of fusion oncogenes has on the generation of translatable mature RNAs and the diversity of fusion transcripts expressed in different cancer subtypes, which can fundamentally influence both tumorigenesis and treatment. We also discuss functional genomic approaches that can be utilized to identify proteins that mediate the processing of fusion pre‐mRNAs. Furthermore, we assert that an enhanced understanding of fusion transcript biogenesis and the diversity of the chimeric RNAs present in fusion‐driven cancers will increase the likelihood of successful application of RNA‐based therapies in this class of tumors. This article is categorized under:RNA Processing > RNA Editing and Modification RNA Processing > Splicing Regulation/Alternative Splicing RNA in Disease and Development > RNA in Disease
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Affiliation(s)
- Carla Neckles
- Functional Genetics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, Maryland
| | - Soumya Sundara Rajan
- Functional Genetics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, Maryland
| | - Natasha J Caplen
- Functional Genetics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, Maryland
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Jin C, Zhu X, Xiao M, Liu S, Liu X, Liu J, Xu X, Yi S, Meng L. A Novel e8a2BCR-ABL1 Fusion Transcript without Insertion Sequence in a Patient with Chronic Myeloid Leukemia. Ann Lab Med 2017; 38:169-171. [PMID: 29214763 PMCID: PMC5736678 DOI: 10.3343/alm.2018.38.2.169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 05/26/2017] [Accepted: 09/25/2017] [Indexed: 11/19/2022] Open
Affiliation(s)
- Caibao Jin
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science andTechnology, China
| | - Xiaojian Zhu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science andTechnology, China
| | - Min Xiao
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science andTechnology, China
| | - Songya Liu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science andTechnology, China
| | - Xian Liu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science andTechnology, China
| | - Jingjing Liu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science andTechnology, China
| | - Xiuwen Xu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science andTechnology, China
| | - Shujuan Yi
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science andTechnology, China
| | - Li Meng
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science andTechnology, China.
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Crampe M, Shakkak F, Kelly J, Hodgson A, Langabeer SE. Chronic myeloid leukemia with a novel e8a1 BCR-ABL1fusion: rapid molecular response with nilotinib. Leuk Lymphoma 2017; 58:1-6. [DOI: 10.1080/10428194.2017.1281413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Mireille Crampe
- Cancer Molecular Diagnostics, St. James’s Hospital, Dublin, Ireland
| | - Fatima Shakkak
- Department of Haematology, Sligo General Hospital, Sligo, Ireland
| | - Johanna Kelly
- Department of Clinical Genetics, Our Lady’s Children’s Hospital, Dublin, Ireland
| | - Andrew Hodgson
- Department of Haematology, Sligo General Hospital, Sligo, Ireland
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9
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Zhang Y, Cheng Z, Yan WZ, Liu SF, Hu CH, Zhang GS. Molecular characterization and therapeutic reaction to dasatinib in a CML patient harboring a novel e8a2 BCR-ABL1 transcript with a somatic mutation in TP53BP2 and cadherin-10 genes. Leuk Lymphoma 2017; 59:233-236. [PMID: 28554234 DOI: 10.1080/10428194.2017.1323269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Yang Zhang
- a Department of Oncology , The Second Xiang-Ya Hospital, Central South University , Changsha , PR China
| | - Zhao Cheng
- b Department of Hematology, Institute of Molecular Hematology , The Second Xiang-Ya Hospital, Central South University , Changsha , PR China
| | - Wen-Zhe Yan
- b Department of Hematology, Institute of Molecular Hematology , The Second Xiang-Ya Hospital, Central South University , Changsha , PR China
| | - Su-Fang Liu
- b Department of Hematology, Institute of Molecular Hematology , The Second Xiang-Ya Hospital, Central South University , Changsha , PR China
| | - Chun-Hong Hu
- a Department of Oncology , The Second Xiang-Ya Hospital, Central South University , Changsha , PR China
| | - Guang-Sen Zhang
- b Department of Hematology, Institute of Molecular Hematology , The Second Xiang-Ya Hospital, Central South University , Changsha , PR China
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10
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Alikian M, Gale RP, Apperley JF, Foroni L. Molecular techniques for the personalised management of patients with chronic myeloid leukaemia. BIOMOLECULAR DETECTION AND QUANTIFICATION 2017; 11:4-20. [PMID: 28331814 PMCID: PMC5348117 DOI: 10.1016/j.bdq.2017.01.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 12/28/2016] [Accepted: 01/18/2017] [Indexed: 12/25/2022]
Abstract
Chronic myeloid leukemia (CML) is the paradigm for targeted cancer therapy. RT-qPCR is the gold standard for monitoring response to tyrosine kinase-inhibitor (TKI) therapy based on the reduction of blood or bone marrow BCR-ABL1. Some patients with CML and very low or undetectable levels of BCR-ABL1 transcripts can stop TKI-therapy without CML recurrence. However, about 60 percent of patients discontinuing TKI-therapy have rapid leukaemia recurrence. This has increased the need for more sensitive and specific techniques to measure residual CML cells. The clinical challenge is to determine when it is safe to stop TKI-therapy. In this review we describe and critically evaluate the current state of CML clinical management, different technologies used to monitor measurable residual disease (MRD) focus on comparingRT-qPCR and new methods entering clinical practice. We discuss advantages and disadvantages of new methods.
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Key Words
- ABL1, Abelson murine leukaemia virus
- ALL, acute lymphoblastic leukaemia
- AP, accelerated phase
- ARQ, armored RNA Quant
- ATP, adenosine triphosphate
- BC, blast crisis
- BCR, breakpoint cluster region
- BM, bone marrow
- BMT, bone marrow transplantation
- Bp, base pair
- CAP, College of American Pathology
- CES, capillary electrophoresis sequencing
- CML
- CML, chronic myeloid leukaemia
- CMR, complete molecular response/remission
- CP, chronic phase
- DESTINY, De-Escalation and Stopping Treatment of Imatinib, Nilotinib or sprYcel in Chronic Myeloid Leukaemia
- DNA, deoxyribonucleic acid
- EAC, Europe Against Cancer
- ELN, European Leukaemia Net
- EURO-SKI, European Stop Tyrosine Kinase Inhibitor Study
- GUSB, glucuronidase beta gene
- IC, inhibotory concentration
- IRIS, interferon and cytarabine versus STI571
- IS, International Scale
- InDels, insertions and deletions
- KDa, Kilo Dalton
- Kbp, Kilo Base Pairs
- LPC, leukemic progenitor cells
- LSC, leukemic stem cell
- LoD, limit of detection
- LoQ, limit of quantification
- M-bcr, major-breakpoint cluster region
- MMR, major molecular response/remission
- MR, deep molecular response/remission
- MRD
- MRD, minimal residual disease
- Mbp, mega base pair
- Molecular monitoring
- NCCN, National Comprehensive Cancer Network
- NEQAS, National External Quality Assessement Service
- NGS
- NGS, next generation sequencing
- NTC, No Template Control
- PB, Peripheral Blood
- PCR, Polymerase Chain Reaction
- PFS, Progression Free Survival
- Ph, Philadelpia
- Q-PCR, quantitative polymerase chain reaction
- QC, Quality Control
- RT, reverse transcription
- RT-dPCR, reverse transcription-digital polymerase chain reaction
- RT-qPCR, reverse transcription-quantitative polymerase chain reaction
- SCT, stem cell transplant
- SMRT, single-molecule real-time sequencing
- STIM, stop imatinib
- TKD, tyrosine kinase domain
- TKI, tyrosine kinase inhibitor
- WHO, World Health Organisation
- ZMW, zero-mode wave-guided
- allo-SCT, Allogeneic Stem Cell Transplantation
- cDNA, coding or complimentary DNA
- dMIQE, Minimum Information for Publication of Quantitative Digital PCR Experiments
- dPCR
- dPCR, digital polymerase chain reaction
- emPCR, emulsion PCR
- gDNA, genomic deoxyribonucleic acid
- m-bcr, minor-breakpoint cluster region
- mRNA, messenger RNA
- nM, manomolar
- μ-bcr, micro-breakpoint cluster region
- μg, microgram
- μl, microliter
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Affiliation(s)
- Mary Alikian
- Centre for Haematology, Department of Medicine, Imperial College London Hammersmith Hospital, London UK; Imperial Molecular Pathology, Imperial College Healthcare Trust, Hammersmith Hospital, London, UK
| | - Robert Peter Gale
- Centre for Haematology, Department of Medicine, Imperial College London Hammersmith Hospital, London UK
| | - Jane F Apperley
- Centre for Haematology, Department of Medicine, Imperial College London Hammersmith Hospital, London UK
| | - Letizia Foroni
- Centre for Haematology, Department of Medicine, Imperial College London Hammersmith Hospital, London UK
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Fu S, Hu Y, Fu Y, Chen F, Liu X, Zhang M, Wang X, Tu S, Zhang J. Novel BCR-ABL1 fusion and leukemic mutations of SETBP1, PAX5, and TP53 detected by next generation sequencing in chronic myeloid leukemia. Cancer Biol Ther 2016; 17:1003-1009. [PMID: 27611742 DOI: 10.1080/15384047.2016.1219821] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Patients with BCR-ABL1 fusion genes are potential candidates for targeted therapy with tyrosine kinase inhibitor (TKI) imatinib. However, novel BCR-ABL1 fusion variants can be undetected by qRT-PCR-based routine molecular screening, affecting immediate patient management and proper treatment selection. In this study, we describe a case of chronic myeloid leukemia (CML) harboring a novel BCR-ABL1 variant gene. Although Fluorescent In situ Hybridization (FISH) analysis suggested Philadelphia (Ph) translocation, qRT-PCR screening failed to detect the presence of a functional fusion transcript, which is critical for selecting targeted therapy against BCR-ABL1 fusion with aberrant kinase activity. Meanwhile, G-band cytogenetic analysis was performed twice without a solid conclusion. To overcome the uncertainty whether TKIs should be used to treat this patient effectively, we performed whole genome sequencing (WGS) in a next-generation sequencing (NGS) platform and discovered an unusual e13a2-like BCR-ABL1 fusion with 9 ABL1 intron 1 nucleotides incorporated into the broken BCR exon 13 to form a novel chimeric exon, which has never been described previously based on the best of our knowledge. Based on FISH and NGS results, the patient was treated with imatinib, showing significant improvement. Moreover, we also detected novel genetic mutations in the known leukemic genes SETBP1, PAX5, and TP53, while their role in the leukemogenesis remains to be determined. In summary, we have identified BCR-ABL1 fusion and other genetic mutations in a diagnostically difficult case of CML, demonstrating that NGS is a powerful diagnostic tool when routine procedures are challenged.
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Affiliation(s)
- Shuang Fu
- a Hematology Laboratory , Shengjing Hospital of China Medical University , Shenyang, Liaoning , China
| | - Yanping Hu
- a Hematology Laboratory , Shengjing Hospital of China Medical University , Shenyang, Liaoning , China
| | - Yu Fu
- a Hematology Laboratory , Shengjing Hospital of China Medical University , Shenyang, Liaoning , China
| | - Fang Chen
- a Hematology Laboratory , Shengjing Hospital of China Medical University , Shenyang, Liaoning , China
| | - Xuan Liu
- a Hematology Laboratory , Shengjing Hospital of China Medical University , Shenyang, Liaoning , China
| | - Minyu Zhang
- a Hematology Laboratory , Shengjing Hospital of China Medical University , Shenyang, Liaoning , China
| | - Xiaohui Wang
- a Hematology Laboratory , Shengjing Hospital of China Medical University , Shenyang, Liaoning , China
| | - Shichun Tu
- b Shanghai Yuanqi Bio-pharmaceutical Company Ltd , Shanghai , China
| | - Jihong Zhang
- a Hematology Laboratory , Shengjing Hospital of China Medical University , Shenyang, Liaoning , China
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12
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Lyu X, Yang J, Wang X, Hu J, Liu B, Zhao Y, Guo Z, Liu B, Fan R, Song Y. A novel BCR-ABL1 fusion gene identified by next-generation sequencing in chronic myeloid leukemia. Mol Cytogenet 2016; 9:47. [PMID: 27350795 PMCID: PMC4922057 DOI: 10.1186/s13039-016-0257-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 06/09/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND BCR-ABL1 fusion proteins contain constitutively active tyrosine kinases that are potential candidates for targeted therapy with tyrosine kinase inhibitors such as imatinib in chronic myeloid leukemia (CML). However, uncharacterized BCR-ABL1 fusion genes can be missed by quantitative RT-PCR (qRT-PCR)-based routine screening methods, causing adverse effect on drug selection and treatment outcome. CASE PRESENTATION In this study, we demonstrated that the next-generation sequencing (NGS) can be employed to overcome this obstacle. Through NGS, we identified a novel BCR-ABL1 fusion gene with breakpoints in the BCR intron 14 and the ABL1 intron 2, respectively, in a rare case of CML. Its mRNA with an e14a3 junction was then detected using customized RT-PCR followed by Sanger sequencing. Subsequently, the patient received targeted medicine imatinib initially at 400 mg/day, and later 300 mg/day due to intolerance reactions. With this personalized treatment, the patient's condition was significantly improved. Interestingly, this novel fusion gene encodes a fusion protein containing a compromised SH3 domain, which is usually intact in the majority of CML cases, suggesting that dysfunctional SH3 domain may be associated with altered drug response and unique clinicopathological manifestations observed in this patient. CONCLUSION We identified a novel BCR-ABL1 fusion gene using NGS in a rare case of CML while routine laboratory procedures were challenged, demonstrating the power of NGS as a diagnostic tool for detecting novel genetic mutations. Moreover, our new finding regarding the novel fusion variant will provide useful insights to improve the spectrum of the genomic abnormalities recognizable by routine molecular screening.
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Affiliation(s)
- Xiaodong Lyu
- School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan 450000 China.,Central Laboratory, the Affiliated Cancer Hospital of Zhengzhou University; Henan Cancer Hospital, Zhengzhou, Henan 450000 China
| | - Jingke Yang
- Department of Hematology, the Affiliated Cancer Hospital of Zhengzhou University; Henan Cancer Hospital, Zhengzhou, Henan 450000 China
| | - Xianwei Wang
- Central Laboratory, the Affiliated Cancer Hospital of Zhengzhou University; Henan Cancer Hospital, Zhengzhou, Henan 450000 China
| | - Jieying Hu
- Central Laboratory, the Affiliated Cancer Hospital of Zhengzhou University; Henan Cancer Hospital, Zhengzhou, Henan 450000 China
| | - Bing Liu
- Central Laboratory, the Affiliated Cancer Hospital of Zhengzhou University; Henan Cancer Hospital, Zhengzhou, Henan 450000 China
| | - Yu Zhao
- Central Laboratory, the Affiliated Cancer Hospital of Zhengzhou University; Henan Cancer Hospital, Zhengzhou, Henan 450000 China
| | - Zhen Guo
- Central Laboratory, the Affiliated Cancer Hospital of Zhengzhou University; Henan Cancer Hospital, Zhengzhou, Henan 450000 China
| | - Bingshan Liu
- School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan 450000 China
| | - Ruihua Fan
- Central Laboratory, the Affiliated Cancer Hospital of Zhengzhou University; Henan Cancer Hospital, Zhengzhou, Henan 450000 China
| | - Yongping Song
- Department of Hematology, the Affiliated Cancer Hospital of Zhengzhou University; Henan Cancer Hospital, Zhengzhou, Henan 450000 China
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13
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Chen L, Wu Y, You Y, Xiao M, Yao Y, Li W. A novel e8a2 BCR-ABL1 intronic fusion through insertion of a chromosome 22 BCR gene fragment into chromosome 9 in an atypical Philadelphia (Ph) chromosome chronic myeloid leukemia patient. Leuk Lymphoma 2016; 57:2930-2933. [PMID: 27118564 DOI: 10.3109/10428194.2016.1173211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Lifeng Chen
- a Department of Hematology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei Province , P.R. China
| | - Yaohui Wu
- a Department of Hematology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei Province , P.R. China
| | - Yong You
- a Department of Hematology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei Province , P.R. China
| | - Min Xiao
- b Department of Hematology , Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei Province , P.R. China
| | - Ye Yao
- c Department of Radiation Oncology and Medical Oncology , Zhongnan Hospital, Wuhan University , Wuhan , Hubei Province , P.R. China.,d Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital , Wuhan University , Wuhan , Hubei Province , P.R. China
| | - Weiming Li
- a Department of Hematology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei Province , P.R. China
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14
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Deshpande PA, Srivastava VM, Mani S, Anandhan S, Meena J, Abraham A, Viswabandya A, George B, Srivastava A, Mathews V, Balasubramanian P. Atypical BCR-ABL1 fusion transcripts in adult B-acute lymphoblastic leukemia, including a novel fusion transcript-e8a1. Leuk Lymphoma 2016; 57:2481-4. [PMID: 26942999 DOI: 10.3109/10428194.2016.1151512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Prashant A Deshpande
- a Department of Haematology , Christian Medical College , Vellore , Tamil Nadu , India
| | - Vivi M Srivastava
- b Cytogenetics Unit , Christian Medical College , Vellore , Tamil Nadu , India
| | - Sathya Mani
- a Department of Haematology , Christian Medical College , Vellore , Tamil Nadu , India
| | | | - J Meena
- a Department of Haematology , Christian Medical College , Vellore , Tamil Nadu , India
| | - Aby Abraham
- a Department of Haematology , Christian Medical College , Vellore , Tamil Nadu , India
| | - Auro Viswabandya
- a Department of Haematology , Christian Medical College , Vellore , Tamil Nadu , India
| | - Biju George
- a Department of Haematology , Christian Medical College , Vellore , Tamil Nadu , India
| | - Alok Srivastava
- a Department of Haematology , Christian Medical College , Vellore , Tamil Nadu , India
| | - Vikram Mathews
- a Department of Haematology , Christian Medical College , Vellore , Tamil Nadu , India
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15
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Huet S, Dulucq S, Chauveau A, Ménard A, Chomel JC, Maisonneuve H, Legros L, Perrin MC, Ferrant E, Moreilhon C, Couturier MA, Sujobert P, Magaud JP, Ugo V, Chabane K, Raynaud S, Hayette S. Molecular characterization and follow-up of five CML patients with new BCR-ABL1 fusion transcripts. Genes Chromosomes Cancer 2015; 54:595-605. [PMID: 26252834 DOI: 10.1002/gcc.22263] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 04/13/2015] [Accepted: 04/13/2015] [Indexed: 02/04/2023] Open
Abstract
We report five chronic myeloid leukaemia (CML) patients in whom we identified and characterized undescribed BCR-ABL1 fusion transcripts. We investigated the precise features of the molecular rearrangements and the minimal residual disease follow-up for these five patients. Three resulted from new rearrangements between the BCR and ABL1 sequences (the breakpoints being located within BCR exon 13 in two cases and within BCR exon 18 in one case). The other two cases revealed a complex e8-[ins]-a2 fusion transcript involving a third partner gene, PRDM12 and SPECC1L, respectively. Moreover, single nucleotide polymorphism-array analysis performed in the latter two cases showed copy number alterations shared by the two patients, thus identifying genes that were deleted during rearrangement and suggesting their potential role in CML pathogenesis. Interestingly, we highlight that the prognosis of alterations, such as the presence of an e8a2 transcript or the deletion of various genes, which have been controversial, may be definitively erased by the introduction of tyrosine kinase inhibitors (TKIs).
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Affiliation(s)
- Sarah Huet
- Laboratoire D'hématologie, Centre De Biologie Sud, Hospices Civils De Lyon, Pierre-Bénite, France
| | - Stéphanie Dulucq
- Laboratoire D'hématologie, Centre Hospitalo-Universitaire De Bordeaux, Bordeaux, France
| | - Aurélie Chauveau
- Laboratoire D'hématologie, Centre Hospitalo-Universitaire Régional De Brest, Brest, France
| | - Audrey Ménard
- Laboratoire D'hématologie, Institut De Biologie, Centre Hospitalo-Universitaire De Nantes, Nantes, France
| | - Jean-Claude Chomel
- Service De Cancérologie Biologique, Centre Hospitalo-Universitaire De Poitiers, Poitiers, France
| | - Hervé Maisonneuve
- Service Clinique d'onco-Hématologie, Centre Hospitalier Départemental Vendée, La-Roche-sur-Yon, France
| | - Laurence Legros
- Service D'hématologie Clinique, Groupe Hospitalier L'archet, Centre Hospitalo-Universitaire De Nice, Nice, France
| | | | - Emmanuelle Ferrant
- Service D'hématologie Clinique, Centre Hospitalo-Universitaire De Dijon, Dijon, France
| | - Chimène Moreilhon
- Laboratoire D'hématologie, Hôpital Pasteur, Centre Hospitalo-Universitaire De Nice, Nice, France
| | - Marie-Anne Couturier
- Service D'hématologie Stérile, Institut Cancérologie-Hématologie, Centre Hospitalo-Universitaire Régional De Brest, Brest, France
| | - Pierre Sujobert
- Laboratoire D'hématologie, Centre De Biologie Sud, Hospices Civils De Lyon, Pierre-Bénite, France
| | - Jean-Pierre Magaud
- Laboratoire D'hématologie, Centre De Biologie Sud, Hospices Civils De Lyon, Pierre-Bénite, France
| | - Valérie Ugo
- Laboratoire D'hématologie, Centre Hospitalo-Universitaire Régional De Brest, Brest, France
| | - Kaddour Chabane
- Laboratoire D'hématologie, Centre De Biologie Sud, Hospices Civils De Lyon, Pierre-Bénite, France
| | - Sophie Raynaud
- Laboratoire D'hématologie, Hôpital Pasteur, Centre Hospitalo-Universitaire De Nice, Nice, France
| | - Sandrine Hayette
- Laboratoire D'hématologie, Centre De Biologie Sud, Hospices Civils De Lyon, Pierre-Bénite, France
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16
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Frederick L, Beardell F, Viswanatha DS. Novel BCR-ABL1 fusion identified by targeted next-generation sequencing in a patient with an atypical myeloproliferative neoplasm. Hum Pathol 2014; 45:1784-9. [PMID: 24927924 DOI: 10.1016/j.humpath.2014.04.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 03/14/2014] [Accepted: 04/14/2014] [Indexed: 11/27/2022]
Abstract
An unusual case of a BCR-ABL1-positive myeloproliferative neoplasm is presented with discordant molecular and cytogenetic characterization at diagnosis. More extensive molecular characterization of the fusion messenger RNA transcript using a next-generation sequencing approach identified a novel BCR-calcineurin-binding protein 1-ABL1 variant, which has not been described previously. This case highlights the potential utility of next-generation sequencing for a single-target application to resolve rare and unusual tumor genetic variants when standard molecular diagnostic methods are inconclusive. Although the relationship of this novel BCR-ABL1 fusion to the atypical pathologic features and initially suboptimal therapeutic response profile remains speculative, this case indicates that accurate molecular characterization of rare variants has diagnostic and potentially prognostic relevance.
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Affiliation(s)
- Lori Frederick
- Division of Hematopathology, Molecular Hematopathology Laboratory, Mayo Clinic, Rochester, MN 55905
| | - Frank Beardell
- Delaware Clinical and Laboratory Physicians, P.A., Newark, DE 19713
| | - David S Viswanatha
- Division of Hematopathology, Molecular Hematopathology Laboratory, Mayo Clinic, Rochester, MN 55905.
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17
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Shaffer LG, Schultz RA, Ballif BC. The use of new technologies in the detection of balanced translocations in hematologic disorders. Curr Opin Genet Dev 2012; 22:264-71. [PMID: 22336526 DOI: 10.1016/j.gde.2012.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 01/11/2012] [Accepted: 01/12/2012] [Indexed: 01/11/2023]
Abstract
The cytogenetic evaluation of hematologic disease can confirm a diagnosis, determine treatment options, and provide prognostic information to the patient. Among the potential cytogenetic aberrations that can be identified are certain balanced translocations with recurrent breakpoints that provide disease classification and define the sites of disease-causing or disease-promoting genes. In this review, we discuss the importance of balanced translocation identification, the methods traditionally used to identify balanced translocations in the cytogenetics laboratory, and the application of new methodologies such as next generation (NextGen) sequencing and array-based translocation identification through a linear amplification application. These new technologies have the potential to identify all currently known diagnostically and prognostically important rearrangements as well as novel alterations that may provide new therapeutic targets to enhance treatment of hematologic disease.
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Affiliation(s)
- Lisa G Shaffer
- Signature Genomic Laboratories, PerkinElmer, Inc., Spokane, WA, USA.
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18
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McCarron SL, Kelly J, Coen N, McCabe S, Fay M, O'Dwyer M, Hayden PJ, Langabeer SE. A novel e8a2 BCR-ABL1 fusion with insertion of RALGPS1 exon 8 in a patient with relapsed Philadelphia chromosome-positive acute lymphoblastic leukemia. Leuk Lymphoma 2011; 52:919-21. [PMID: 21338279 DOI: 10.3109/10428194.2011.555025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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19
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Branford S, Hughes TP. Practical Considerations for Monitoring Patients With Chronic Myeloid Leukemia. Semin Hematol 2010; 47:327-34. [DOI: 10.1053/j.seminhematol.2010.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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20
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Abstract
ABL-family proteins comprise one of the best conserved branches of the tyrosine kinases. Each ABL protein contains an SH3-SH2-TK (Src homology 3-Src homology 2-tyrosine kinase) domain cassette, which confers autoregulated kinase activity and is common among nonreceptor tyrosine kinases. This cassette is coupled to an actin-binding and -bundling domain, which makes ABL proteins capable of connecting phosphoregulation with actin-filament reorganization. Two vertebrate paralogs, ABL1 and ABL2, have evolved to perform specialized functions. ABL1 includes nuclear localization signals and a DNA binding domain through which it mediates DNA damage-repair functions, whereas ABL2 has additional binding capacity for actin and for microtubules to enhance its cytoskeletal remodeling functions. Several types of posttranslational modifications control ABL catalytic activity, subcellular localization, and stability, with consequences for both cytoplasmic and nuclear ABL functions. Binding partners provide additional regulation of ABL catalytic activity, substrate specificity, and downstream signaling. Information on ABL regulatory mechanisms is being mined to provide new therapeutic strategies against hematopoietic malignancies caused by BCR-ABL1 and related leukemogenic proteins.
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Affiliation(s)
- John Colicelli
- Department of Biological Chemistry, Molecular Biology Institute and Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
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21
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Jurcek T, Razga F, Jeziskova I, Dvorakova D, Zackova D, Tomasikova L, Oltova A, Mayer J. Failure of molecular diagnostics in chronic myeloid leukemia: an aberrant form of e13a2 BCR-ABL transcript causing false-negative results by standard polymerase chain reaction. Leuk Lymphoma 2010; 51:558-61. [PMID: 20148758 DOI: 10.3109/10428190903572219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
MESH Headings
- Adult
- Exons
- False Negative Reactions
- Fusion Proteins, bcr-abl/metabolism
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Male
- Models, Genetic
- Pathology, Molecular/methods
- Polymerase Chain Reaction/methods
- Proto-Oncogene Proteins c-bcr/genetics
- Reverse Transcriptase Polymerase Chain Reaction
- Translocation, Genetic
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22
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Weerkamp F, Dekking E, Ng YY, van der Velden VHJ, Wai H, Böttcher S, Brüggemann M, van der Sluijs AJ, Koning A, Boeckx N, Van Poecke N, Lucio P, Mendonça A, Sedek L, Szczepański T, Kalina T, Kovac M, Hoogeveen PG, Flores-Montero J, Orfao A, Macintyre E, Lhermitte L, Chen R, Brouwer-De Cock KAJ, van der Linden A, Noordijk AL, Comans-Bitter WM, Staal FJT, van Dongen JJM. Flow cytometric immunobead assay for the detection of BCR-ABL fusion proteins in leukemia patients. Leukemia 2009; 23:1106-17. [PMID: 19387467 DOI: 10.1038/leu.2009.93] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BCR-ABL fusion proteins show increased signaling through their ABL tyrosine kinase domain, which can be blocked by specific inhibitors, thereby providing effective treatment. This makes detection of BCR-ABL aberrations of utmost importance for diagnosis, classification and treatment of leukemia patients. BCR-ABL aberrations are currently detected by karyotyping, fluorescence in situ hybridization (FISH) or PCR techniques, which are time consuming and require specialized facilities. We developed a simple flow cytometric immunobead assay for detection of BCR-ABL fusion proteins in cell lysates, using a bead-bound anti-BCR catching antibody and a fluorochrome-conjugated anti-ABL detection antibody. We noticed protein stability problems in lysates caused by proteases from mature myeloid cells. This problem could largely be solved by adding protease inhibitors in several steps of the immunobead assay. Testing of 145 patient samples showed fully concordant results between the BCR-ABL immunobead assay and reverse transcriptase PCR of fusion gene transcripts. Dilution experiments with BCR-ABL positive cell lines revealed sensitivities of at least 1%. We conclude that the BCR-ABL immunobead assay detects all types of BCR-ABL proteins in leukemic cells with high specificity and sensitivity. The assay does not need specialized laboratory facilities other than a flow cytometer, provides results within approximately 4 h, and can be run in parallel to routine immunophenotyping.
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Affiliation(s)
- F Weerkamp
- Department of Immunology, Erasmus MC, Rotterdam, The Netherlands
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23
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Park IJ, Lim YA, Lee WG, Park JS, Kim HC, Lee HJ, Cho SR. A case of chronic myelogenous leukemia with e8a2 fusion transcript. ACTA ACUST UNITED AC 2008; 185:106-8. [DOI: 10.1016/j.cancergencyto.2008.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2008] [Revised: 05/30/2008] [Accepted: 06/05/2008] [Indexed: 10/21/2022]
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24
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Burmeister T, Reinhardt R. A multiplex PCR for improved detection of typical and atypical BCR-ABL fusion transcripts. Leuk Res 2007; 32:579-85. [PMID: 17928051 DOI: 10.1016/j.leukres.2007.08.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Revised: 08/19/2007] [Accepted: 08/20/2007] [Indexed: 11/17/2022]
Abstract
RT-PCR is the method of choice for detecting BCR-ABL in CML and ALL. The three predominant mRNA transcripts found are e1a2 (in ALL), e13a2, and e14a2 (in CML and ALL). However, a number of "atypical"BCR-ABL transcripts (e1a3, e13a3, e14a3, e19a2, e6a2, e8a2, etc.) resulting from chromosomal breakpoints outside ABL intron 1 or BCR intron 1, 13 or 14, respectively, have been reported. These atypical transcripts may escape detection when using methods that are optimized to detect just the typical ones. We present here a novel, fast, and reliable multiplex PCR for improved detection of typical and atypical BCR-ABL transcripts.
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MESH Headings
- DNA Primers
- Electrophoresis, Polyacrylamide Gel
- Fusion Proteins, bcr-abl/classification
- Fusion Proteins, bcr-abl/genetics
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- RNA, Messenger/genetics
- RNA, Neoplasm/genetics
- Reverse Transcriptase Polymerase Chain Reaction
- Sensitivity and Specificity
- Transcription, Genetic
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Affiliation(s)
- Thomas Burmeister
- Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik III, Hindenburgdamm 30, 12200 Berlin, Germany.
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25
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van der Velden VHJ, Beverloo HB, Hoogeveen PG, Zwaan CM. A novel BCR-ABL fusion transcript (e18a2) in a child with chronic myeloid leukemia. Leukemia 2007; 21:833-5. [PMID: 17268511 DOI: 10.1038/sj.leu.2404580] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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26
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Tchirkov A, Couderc JL, Périssel B, Goumy C, Regnier A, Uhrhammer N, Verrelle P, Berger M. Major molecular response to imatinib in a patient with chronic myeloid leukemia expressing a novel form of e8a2 BCR-ABL transcript. Leukemia 2006; 20:167-8. [PMID: 16270035 PMCID: PMC1931492 DOI: 10.1038/sj.leu.2404012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
MESH Headings
- Adult
- Benzamides
- Fusion Proteins, bcr-abl/genetics
- Gene Expression Regulation, Leukemic
- Genetic Variation
- Humans
- Imatinib Mesylate
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Male
- Piperazines/therapeutic use
- Pyrimidines/therapeutic use
- RNA, Messenger/genetics
- Remission Induction
- Reverse Transcriptase Polymerase Chain Reaction
- Transcription, Genetic
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Affiliation(s)
- Andrei Tchirkov
- Centre Jean Perrin
58, rue Montalembert -
63011 Clermont-Ferrand,FR
- Service de Cytogénétique Médicale
CHU Clermont-FerrandFaculté de médecine
Clermont-Ferrand,FR
- * Correspondence should be adressed to: Andrei Tchirkov
| | - Jean-Louis Couderc
- Interactions génétiques et cellulaires au cours de la différenciation
INSERM : U384Université d'Auvergne - Clermont-Ferrand IFaculté de Médecine
28, Place Henri Dunant
63001 Clermont-Ferrand,FR
| | - Bernard Périssel
- Service de Cytogénétique Médicale
CHU Clermont-FerrandFaculté de médecine
Clermont-Ferrand,FR
| | - Carole Goumy
- Service de Cytogénétique Médicale
CHU Clermont-FerrandFaculté de médecine
Clermont-Ferrand,FR
| | | | - Nancy Uhrhammer
- Centre Jean Perrin
58, rue Montalembert -
63011 Clermont-Ferrand,FR
| | - Pierre Verrelle
- Centre Jean Perrin
58, rue Montalembert -
63011 Clermont-Ferrand,FR
| | - Marc Berger
- Service d'Hématologie
CHU Clermont-FerrandFaculté de médecine
Clermont-Ferrand,FR
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27
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Cayuela JM, Rousselot P, Nicolini F, Espinouse D, Ollagnier C, Bui-Thi MH, Chabane K, Raffoux E, Callet-Bauchu E, Tigaud I, Magaud JP, Hayette S. Identification of a rare e8a2 BCR-ABL fusion gene in three novel chronic myeloid leukemia patients treated with imatinib. Leukemia 2005; 19:2334-6. [PMID: 16224485 DOI: 10.1038/sj.leu.2403986] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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