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mRNA Using Real-Time Reverse-Transcription Polymerase Chain Reaction






From the Department of Medicine,
*
Roswell Park Cancer Institute, Buffalo, New York; Applied Biosystems,
Foster City, California; the Department of Pathology,
University of New Mexico Cancer Research Facility, Albuquerque, New Mexico; and the Department of Oncology,
Montefiore Medical Center and Albert Einstein Cancer Center, Bronx, New York
We have developed a sensitive and quantitative
reverse-transcription polymerase chain reaction (RT-PCR) assay for
detection of PML-RAR
, the fusion oncogene present as
a specific marker in >99% of cases of acute promyelocytic leukemia
(APL). The assay is linear over at least 5 orders of magnitude of input
DNA or RNA, and detects as few as 4 copies of PML-RAR
plasmid DNA. PML-RAR
transcripts could be detected in mixtures
containing 2 to 5 pg of RNA from fusion-containing cells in a
background of 1 µg of RNA from PML-RAR
-negative cells. Using 1.0
to 2.5 µg of input RNA, the sensitivity of the assay was
between 10-5 and 10-6. Furthermore,
determination of GAPDH copy number in each reaction allowed an accurate
assessment of sample-to-sample variation in RNA quality and reaction
efficiency, with consequent definition of a detection limit for
each sample assayed. Using an internal calibrator, assay
precision was high, with coefficients of variation between 10
and 20%. An interlaboratory study using coded samples demonstrated
excellent reproducibility and high concordance between laboratories.
This assay will be used to test the hypothesis that sensitive and
quantitative measurement of leukemic burden, during or after
therapy of APL, can stratify patients into discrete risk
groups, and thereby serve as a basis for risk-adapted therapy
in APL.
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