RARA and PML genes in acute promyelocytic leukemia.

Acute promyelocytic leukemia (APL) is characterized by a specific chromosome translocation t(15;17). Recently, using molecular biology techniques, a number of laboratories have demonstrated that the gene coding for the retinoic acid receptor alpha (RARA), normally located on chromosome 17, is disrupted by the t(15;17) and fused with the PML gene on chromosome 15. The chromosome 17 breaks were mapped consistently within the second intron of the RARA gene while the chromosome 15 breaks were clustered in two limited regions within the PML gene. Molecular cloning and sequence analysis of the PML gene demonstrated a complex splicing pattern and this gene may encode a transcription factor. Different isoforms of the PML-RARA fusion transcripts were discovered which are produced as a result of distinct PML gene rearrangements. Sequence analysis of the reciprocal products of the translocation t(15;17) in some APL cases suggested the implication of topoisomerase II in mediating the DNA recombination. The RT/PCR procedure has been established to characterize the expression patterns of the PML-RARA fusion gene and to detect minimal residual disease (MRD). The biological activity of the PML-RARA fusion gene and its isoforms should be further explored.