Report of PRPF19 as a novel partner of RARG and the recurrence of interposition-type fusion in variant acute promyelocytic leukemia.
Huanling WuHongjun LiXiaosu ZhouZongchen ZhaoPanxiang CaoLi LiXiaoli MaLili YuanFang WangYang ZhangJiaqi ChenJiancheng FangMing LiuMingyue LiuXue ChenHongxing LiuPublished in: Hematological oncology (2023)
Acute promyelocytic leukemia (APL) is a unique subtype of acute myeloid leukemia (AML) which is characterized by specific clinical and biological features. Typical APL cases are caused by PML::RARA fusion gene and are exquisitely sensitive to all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). Rarely, APLs are caused by atypical fusions involving RARA or, in fewer cases still, fusions involving other members of the retinoic acid receptors (RARB or RARG). To date, seven partner genes of RARG have been reported in a total of 18 cases of variant APL. Patients with RARG fusions showed distinct clinical resistance to ATRA and had poor outcomes. Here, we report PRPF19 gene as a novel partner of RARG and identify a rare interposition-type gene fusion in a variant APL patient with a rapidly fatal clinical course. The incomplete ligand-binding domain of RARG in the fusion protein may account for the clinical ATRA resistance in this patient. These results broaden the spectrum of variant APL associated molecular aberrations. Accurately and timely identification of these rare gene fusions in variant APL is essential to guide therapeutic decisions.
Keyphrases
- acute myeloid leukemia
- copy number
- genome wide
- genome wide identification
- liver failure
- case report
- genome wide analysis
- bone marrow
- hiv testing
- dna methylation
- drinking water
- allogeneic hematopoietic stem cell transplantation
- respiratory failure
- men who have sex with men
- drug induced
- aortic dissection
- transcription factor
- extracorporeal membrane oxygenation
- hepatitis b virus
- human immunodeficiency virus
- single molecule
- adipose tissue