Mutations and laboratory diagnosis in acute promyelocytic leukemia

Authors

DOI:

https://doi.org/10.56294/sctconf2024554

Keywords:

Acute Promyelocytic Leukemia, Acute Myelocytic Leukemia M3, Laboratory Diagnosis, Mutation

Abstract

Introduction: acute Promyelocytic Leukemia (APL) is a unique subtype of acute myeloid leukemia (AML) characterized by proliferation and accumulation of abnormal promyelocytes in the bone marrow. It arises from a balanced translocation between chromosomes 15 and 17, involving the retinoic acid receptor alpha (RARA) gene on chromosome 17 and the promyelocytic leukemia (PML) gene. It has a higher incidence in young adults.

Objective: to establish the mutations associated with acute promyelocytic leukemia and the techniques that aid in its clinical diagnosis.

Method: a systematic review of 19 scientific articles published in the databases of PubMed, Scopus, Google Scholar and the Virtual Library of the University of Granada was carried out. The data collected focused on acute promyelocytic leukemia, acquired, secondary or somatic mutations and laboratory diagnosis.

Results: of a total of 1730 patients 67.7% had the t(15;17) mutation, of 682 patients 26.7% had the FLT3-ITD mutation and of 175 patients 16% had the FLT3-D835 mutation. Laboratory diagnosis is based on morphological evaluation of promyelocytes, hemostasis tests, biochemical tests Immunophenotyping and molecular cytogenetics.

Conclusions: the mutation associated with APL is the promyelocytic leukemia/retinoic acid receptor alpha (PML-RARA) gene, the same that presents a t(15;17), secondary mutations or somatic mutations such as (FLT3-ITD or FLT3-D835) were also known. Multiparametric flow cytometry is one of the most widely used techniques for the diagnosis of APL, allowing the determination of cell morphology and immunophenotypes

References

1. Ng CH, Chng WJ. Recent advances in acute promyelocytic leukaemia. F1000Research. 2017;6(0).

2. Yilmaz M, Kantarjian H, Ravandi F. Acute promyelocytic leukemia current treatment algorithms. Blood Cancer J [Internet]. 2021;11(6). Available from: http://dx.doi.org/10.1038/s41408-021-00514-3

3. Leukemia and Society Lymphoma. Información sobre la leucemia promielocítica aguda. WwwLlsOrg [Internet]. 2015;1–9. Available from: https://www.lls.org/sites/default/files/National/USA/Pdf/Publications/Spanish_APL_Fact Sheet 12_15.pdf

4. Mejía Buriticá L, Ocampo M, Torres Hernández JD, Ospina Ospina S, Vásquez Palacio G. Caracterización clínica y citogenética de pacientes con leucemia promielocítica aguda atendidos en un hospital universitario en la ciudad de Medellín, Colombia. Rev Colomb Hematol y Oncol. 2022;8(Suplemento 1):40–3.

5. Noguera NI, Catalano G, Banella C, Divona M, Faraoni I, Ottone T, et al. Acute Promyelocytic Leukemia : Update on the Mechanisms of Leukemogenesis , Resistance and on. Cancers (Basel). 2019;11(1591):1–21.

6. Pérez AC, Prada-Arismendy J, Castillo-Peñuela E, Castellanos W. Detección del gen fusión PML-RARA en pacientes colombianos con leucemia mieloide aguda. Ces Med. 2019;33(2):88– 99.

7. David S, Mathews V. Mechanisms and management of coagulopathy in acute promyelocytic leukemia. Thromb Res [Internet]. 2018;164(January):S82–8. Available from: https://doi.org/10.1016/j.thromres.2018.01.041

8. Mantha S, Tallman MS, Soff GA. What’s new in the pathogenesis of the coagulopathy in acute promyelocytic leukemia? Curr Opin Hematol. 2016;23(2):121–6.

9. Wang ZY, Chen Z. Acute promyelocytic leukemia: From highly fatal to highly curable. Blood. 2008;111(5):2505–15.

10. Shen PF. MOLECULAR MECHANISMS OF CHEMOPREVENTION AND THERAPY OF CANCER BY RETINOIDS. Vol. 9, Frontiers in Bioscience. 2663.

11. Urrútia G, Bonfill X. Declaración PRISMA: una propuesta para mejorar la publicación de revisiones sistemáticas y metaanálisis. Med Clin. 2010;135(11):507–11.

12. Kárai B, Habók M, Reményi G, Rejtő L, Ujfalusi A, Kappelmayer J, et al. A novel flow cytometric method for enhancing acute promyelocytic leukemia screening by multidimensional dot-plots. Ann Hematol. 2019;98(6):1413–20.

13. Matarraz S, Leoz P, Fernández C, Colado E, Chillón MC, Vidriales MB, et al. Basophil-lineage commitment in acute promyelocytic leukemia predicts for severe bleeding after starting therapy. Mod Pathol. 2018;31(8):1318–31.

14. Chen Z, Li Y, Tong Y, Gao Q, Mao X, Zhang W, et al. Stepwise discriminant function analysis for rapid identification of acute promyelocytic leukemia from acute myeloid leukemia with multiparameter flow cytometry. Int J Hematol. 2016;103(3):306–15.

15. Pérez AC, Prada-arismendy J. Detección del gen fusión PML-RARA en pacientes colombianos con leucemia mieloide aguda. CES Med. 2019;33(2):88–99.

16. Picharski GL, Andrade DP, Fabro ALMR, Lenzi L, Tonin FS, Ribeiro RC, et al. The impact of Flt3 gene mutations in acute promyelocytic leukemia: A meta-analysis. Cancers (Basel). 2019;11(9):1–14.

17. Montañés MR V. Promielocitos atípicos con astillas

Downloads

Published

2024-05-07

How to Cite

1.
Perez Laborde EJ, Freire RDA, Rueda MCY, Zúñiga Sosa EA. Mutations and laboratory diagnosis in acute promyelocytic leukemia. Salud, Ciencia y Tecnología - Serie de Conferencias [Internet]. 2024 May 7 [cited 2024 Nov. 21];3:554. Available from: https://conferencias.ageditor.ar/index.php/sctconf/article/view/1106