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Prospective BCR-ABL analysis by polymerase chain reaction (RT-PCR) in adult acute B-lineage lymphoblastic leukemia: reliability of RT-nested-PCR and comparison to cytogenetic data

Leukemia volume 15, pages 1834–1840 (2001)Cite this article

Abstract

The reliability of routine BCR-ABL RT-nested-PCR was evaluated in 1453 B-lineage ALL or hybrid leukemia at initial diagnosis by RT-nested-PCR. All BCR-ABL-positive (n = 642) and 176 BCR-ABL-negative samples underwent a second RT-PCR. In 518 patients, karyotyping and/or FISH was compared to the BCR-ABL status. The second RT-PCR revealed in 155/642 initially positive samples a divergent result (153 BCR-ABL-negative, two other transcripts) that in most cases turned out to be caused by contaminations in the first RT-nested-PCR. Confirmatory RT-PCR detected 2/176 false negative first RT-nested-PCR results. Thirty-nine specimens remained ambiguous despite different RT-PCR approaches. As far as cytogenetic evaluation and FISH is available (n = 23), the majority but not all patients with an ambiguous RT-PCR result were Ph-negative (n = 18). RT-nested-PCR and cytogenetics yielded in 346 of 383 evaluable samples a concordant result. Differing results are given and account in part to the lower sensitivity of karyotyping. Taken together, confirmed RT-PCR detected BCR-ABL fusion transcripts consistently in 487 out of 1453 ALL samples (c-ALL: 43%, pre-B ALL: 34%, pro-B ALL: 5%, B-ALL: 0%, hybrid leukemia: 5/11). Since false positive initial RT-nested-PCR data were frequent, either confirmatory second RT-PCR or FISH analysis is warranted to guarantee sensitive and reliable results of utmost clinical relevance.

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Acknowledgements

The excellent technical assistance of A Sindram, P Haveman, S Havemann, D Erz, K Weidenauer, R Bielen, E Strohmaier, A Wunderlich, U Spadinger and H Kessler is gratefully acknowledged. This work was supported by the Deutsche Krebshilfe, Federal Republic of Germany, Contract No. M84/92Hol and the Federal Ministry of Education and Research, Federal Republic of Germany, Contract No. 01ZP88045.

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Authors and Affiliations

  1. Department of Hematology, University Hospital Benjamin Franklin, Berlin, Germany

    B Gleißner, E Thiel & J Maurer

  2. Department of Clinical Genetics, Philipps University, Marburg, Germany

    H Rieder

  3. Institute for Medical Biology, University of Vienna, Vienna, Austria

    C Fonatsch

  4. Institute of Human Genetics, University of Heidelberg, Germany

    LAJ Janssen, JWG Janssen & CR Bartram

  5. Department of Human Genetics, University Hospital Ulm, Germany

    B Heinze

  6. Medical Clinic III, University Hospital Grosshadern, Munich, Germany

    C Schoch

  7. Department of Hematology, Internal Medicine, University of Frankfurt, Frankfurt, Germany

    N Goekbuget & D Hoelzer

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Gleißner, B., Rieder, H., Thiel, E. et al. Prospective BCR-ABL analysis by polymerase chain reaction (RT-PCR) in adult acute B-lineage lymphoblastic leukemia: reliability of RT-nested-PCR and comparison to cytogenetic data. Leukemia 15, 1834–1840 (2001). https://doi.org/10.1038/sj.leu.2402304

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