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2016 ; 11
(1
): 89
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Multiplexed automated digital quantification of fusion transcripts: comparative
study with fluorescent in-situ hybridization (FISH) technique in acute leukemia
patients
#MMPMID27632978
Akhter A
; Mughal MK
; Elyamany G
; Sinclair G
; Azma RZ
; Masir N
; Shuib S
; Rashid-Kolvear F
; Shabani-Rad MT
; Stewart DA
; Mansoor A
Diagn Pathol
2016[Sep]; 11
(1
): 89
PMID27632978
show ga
BACKGROUND: The World Health Organization (WHO) classification system defines
recurrent chromosomal translocations as the sole diagnostic and prognostic
criteria for acute leukemia (AL). These fusion transcripts are pivotal in the
pathogenesis of AL. Clinical laboratories universally employ conventional
karyotype/FISH to detect these chromosomal translocations, which is complex,
labour intensive and lacks multiplexing capacity. Hence, it is imperative to
explore and evaluate some newer automated, cost-efficient multiplexed
technologies to accommodate the expanding genetic landscape in AL. METHODS:
"nCounter® Leukemia fusion gene expression assay" by NanoString was employed to
detect various fusion transcripts in a large set samples (n?=?94) utilizing RNA
from formalin fixed paraffin embedded (FFPE) diagnostic bone marrow biopsy
specimens. This series included AL patients with various recurrent translocations
(n?=?49), normal karyotype (n?=?19), or complex karyotype (n?=?21), as well as
normal bone marrow samples (n?=?5). Fusion gene expression data were compared
with results obtained by conventional karyotype and FISH technology to determine
sensitivity/specificity, as well as positive /negative predictive values.
RESULTS: Junction probes for PML/RARA; RUNX1-RUNX1T1; BCR/ABL1 showed 100 %
sensitivity/specificity. A high degree of correlation was noted for MLL/AF4 (85
sensitivity/100 specificity) and TCF3-PBX1 (75 % sensitivity/100 % specificity)
probes. CBFB-MYH11 fusion probes showed moderate sensitivity (57 %) but high
specificity (100 %). ETV6/RUNX1 displayed discordance between fusion transcript
assay and FISH results as well as rare non-specific binding in AL samples with
normal or complex cytogenetics. CONCLUSIONS: Our study presents preliminary data
with high correlation between fusion transcript detection by a throughput
automated multiplexed platform, compared to conventional karyotype/FISH technique
for detection of chromosomal translocations in AL patients. Our preliminary
observations, mandates further vast validation studies to explore automated
molecular platforms in diagnostic pathology.