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Acute Promyelocytic Leukemia (APL)

Aberrant promoter methylation of the retinoic acid receptor alpha gene in acute promyelocytic leukemia

Leukemia volume 19, pages 2241–2246 (2005)Cite this article

Abstract

The retinoic acid receptor alpha (RARA) gene is disrupted by PML/RARA fusion in acute promyelocytic leukemia (APL). The P2 promoter of RARA, controlling the RARα2 isoform, contains an RA-responsive element and may be targeted in APL. To test whether aberrant methylation of P2 was involved, 47 APL at diagnosis, 16 APL at first relapse, 50 acute myeloid leukemia (AML) and 22 acute lymphoblastic leukemia (ALL) were tested by methylation-specific polymerase chain reaction. RARA P2 methylation was highly associated with APL (APL: 25/63 vs AML/ALL: 2/75, P<0.0001). P2 methylation occurred at similar frequencies in APL at diagnosis and relapse, suggesting it was an initiating leukemogenic event. In the APL line NB4, RARα2 was not expressed, with the untranslocated RARA shown to be P2 methylated. 5-Azacytadine treatment of NB4 led to progressive P2 demethylation and re-expression of RARα2, confirming that RARA methylation collaborated with PML/RARA in totally suppressing RARα. In APL, RARA P2 methylation was unrelated to gender, age, presenting leukocyte counts and additional cytogenetic aberrations. For APL patients receiving all-trans retinoic acid for induction, P2 methylation did not affect the complete remission rates and survivals. RARA is the first myeloid-specific transcription factor shown to be dysregulated by both translocation and aberrant methylation.

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Acknowledgements

We thank Professor LC Chan, Drs Edmond Ma and Clarence Lam for helping with the diagnosis, and the University Research Fund and Kadoorie Charitable Foundation for funding support.

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Authors and Affiliations

  1. Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong

    C-S Chim, S-Y Wong, A Pang, P Chu & Y-L Kwong

  2. Department of Medicine, Queen Elizabeth Hospital, Hong Kong

    J S Lau

  3. Department of Pathology, Queen Elizabeth Hospital, Hong Kong

    K-F Wong

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  1. C-S Chim
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Correspondence to Y-L Kwong.

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Chim, CS., Wong, SY., Pang, A. et al. Aberrant promoter methylation of the retinoic acid receptor alpha gene in acute promyelocytic leukemia. Leukemia 19, 2241–2246 (2005). https://doi.org/10.1038/sj.leu.2403937

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