Abstract

Chromosome rearrangements and fusion genes present major portion of leukemogenesis and contribute to leukemic subtypes. It is practical and helpful to detect the fusion genes in clinic diagnosis of leukemia. Present application of reverse transcription polymerase chain reaction (RT-PCR) method to detect the fusion gene transcripts is effective, but time- and labor-consuming. To set up a simple and rapid system, we established a method that combined multiplex RT-PCR and microarray. We selected 15 clinically most frequently observed chromosomal rearrangements generating more than 50 fusion gene variants. Chimeric reverse primers and chimeric PCR primers containing both gene-specific and universal sequences were applied in the procedure of multiplex RT-PCR, and then the PCR products hybridized with a designed microarray. With this approach, among 200 clinic samples, 63 samples were detected to have gene rearrangements. All the detected fusion genes positive and negative were validated with RT-PCR and Sanger sequencing. Our data suggested that the RT-PCR-microarray pipeline could screen 15 partner gene pairs simultaneously at the same accuracy of the fusion gene detection with regular RT-PCR. The pipeline showed effectiveness in multiple fusion genes screening in clinic samples.

Highlights

  • Myeloid neoplasms and acute leukemia encompass many different clinical and pathological entities, some with unique genetic features and reflection on risk-stratification and appropriate therapy strategies

  • According to the World Health Organization (WHO) 2008 classification [1, 2], acute myelogeneous leukemia (AML), acute lymphoblastic leukemia (ALL), and chronic myelogenous leukemia (CML) are categorized by the presence of specific balanced chromosomal translocations: AML is associated with t(8;21)(q22;q22), inv(16)(p13q22) or t(16;16)(p13;q22), t(15;17)(q22;q12), and 11q23/MLL abnormalities; ALL is mainly associated with t(12;21)(p13;q22), t(9;22)(q34;q11.2), and t(1;19)(q23;p13); and CML is characterized by the Ph+ chromosome or t(9;22)(q34;q11.2)

  • Monoplex or multiplex reverse transcription polymerase chain reaction (RT-PCR) techniques have been increasingly used to characterize chromosomal translocations found in leukemic cells, with numerous advantages over traditional cytogenetics and fluorescence in situ hybridization (FISH), including shorter turnaround time, no requirement for dividing cells, and detection of cryptic translocations

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Summary

Introduction

Myeloid neoplasms and acute leukemia encompass many different clinical and pathological entities, some with unique genetic features and reflection on risk-stratification and appropriate therapy strategies. As there are many distinct genetic alterations in various leukemia subtypes, it would be extremely labor intensive to evaluate specific fusions via a panel of individual monoplex assays. This can be avoided by the use of multiplex RT-PCR assays with various downstream detection methods, such as gel-based techniques and bead array [7,8,9,10]. Two biochip-based diagnostic systems were reported: a gelbased biochip by Nasedkina et al [11, 12] and MLLFusionChip and AMLFusionChip from France [13, 14] In these previous works, the gel-based biochip only targeted 7 chromosomal translocations, addressing 13 fusion variants in sum, while other two chips covered certain leukemia group. We planned to make RT-PCR-microarray assay much easier, hoping to detect the frequently occurring and well-defined translocations in leukemia

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