The added values of multiplex reverse transcriptase-PCR followed by mutation screening in the initial evaluation of acute leukemia

Abstract

Introduction: This study investigates the benefits of using multiple reverse transcriptase-PCR (RT-PCR) in addition to standard kar} ig during the initial evaluation of acute leukemia.

Methods: A total of 1114 consecutive specimens from patients with acute leukemia were tested using a commercial multiplex RT-PCR kit (HemaVision, DNA Diagnostic). NPMI and CEBPA mutations were selectively tested in acute myeloid leukemia (AML) patients with multiplex RT-PCR negativity.

Results: In specimens with optimal cytogenetics, the frequency of recurrent translocations was 313%, and cryptic translocations were detected in 2.1% of samples. The concordance rate between karyotyping and multiplex RT-PCR was 97.5%. In addition to the established functions, we demonstrated the additional benefits of multiplex RT-PCR, including successful molecular characterization, even in cytogenetically suboptimal specimens (5.7%); detection of submicroscopic aberrations (1.0%); detection of rare but potentially significant translocations or variants (2,5%); selection of AML candidates for mutation analysis (68,3%); and finally exclusion of recurrent anslocations in patients with acute lymphoblastic leukemia or mixed phenotype acute leukemia (22.5%).

Conclusion: We reconfirmed the accuracy and reliability of multiplex RT-PCR for diagnosing acute leukemia and demonstrated additional advantages of this system for the initial evaluation of acute leukemia. Thus, multiplex RT-PCR is worth considering in diagnostic testing of acute leukemias.