Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer. 2010 Jan 15;116(2):369-76. doi: 10.1002/cncr.24775.
The authors evaluated the utility of immunofluorescence staining with an antipromyelocytic leukemia (anti-PML) antibody for patients with a suspected diagnosis of new or relapsed acute promyelocytic leukemia (APL) and correlated the findings with the results of other established diagnostic modalities.
Bone marrow (BM) and/or peripheral blood (PB) smears from 349 patients in whom the diagnosis of APL was considered were assessed with the anti-PML antibody using immunofluorescence. The study group included 199 patients with confirmed APL and 150 with other conditions. The results of conventional cytogenetics, reverse transcription polymerase chain reaction (RT-PCR), and fluorescence in situ hybridization (FISH) performed on these patients were correlated with the PML results.
Among patients with confirmed APL, anti-PML antibody was positive in 182 of 184 BM and 32 of 33 PB smears. Conventional cytogenetics demonstrated t(15;17)(q22;q12) in 166 of 182 (91%) patients; 10 had a normal karyotype, 4 had insufficient mitoses to grow in culture, 1 was inconclusive, and 1 was 48, XX, +8, +8. Anti-PML staining was positive in 9 of 10 with a normal karyotype and in all 4 cases with insufficient mitoses. RT-PCR and FISH were positive for PML-retinoic acid receptor-alpha in 169 of 172 (98%) and 90 of 94 (96%) cases, respectively. Among the patients without APL, 148 of 150 (98.6%) were negative with anti-PML antibody. The sensitivity and specificity of the test were 98.9% and 98.7%, respectively.
PML immunofluorescence staining is a rapid (<4 hours turnaround time) and reliable frontline diagnostic approach that can facilitate initiation of targeted therapy, particularly in clinical settings where cytogenetic and molecular testing are not readily available.
作者评估了抗早幼粒细胞白血病（anti-PML）抗体的免疫荧光染色在疑似新发或复发急性早幼粒细胞白血病（APL）患者中的应用，并将结果与其他既定诊断方法的结果进行了关联。
对 349 例疑似 APL 患者的骨髓（BM）和/或外周血（PB）涂片进行了抗 PML 抗体的免疫荧光检测。研究组包括 199 例确诊的 APL 患者和 150 例其他疾病患者。对这些患者进行了常规细胞遗传学、逆转录聚合酶链反应（RT-PCR）和荧光原位杂交（FISH）检测，并与 PML 结果进行了关联。
在确诊的 APL 患者中，抗 PML 抗体在 184 例 BM 涂片和 33 例 PB 涂片中有 182 例阳性。常规细胞遗传学显示 t(15;17)(q22;q12)在 166 例患者中占 91%；10 例患者核型正常，4 例患者有丝分裂不足无法进行培养，1 例结果不确定，1 例为 48, XX, +8, +8。核型正常的 10 例中有 9 例抗 PML 染色阳性，有丝分裂不足的 4 例全部阳性。RT-PCR 和 FISH 对 PML-视黄酸受体-α的检测分别在 172 例患者中的 169 例（98%）和 94 例患者中的 90 例（96%）中阳性。在非 APL 患者中，150 例患者中 148 例（98.6%）抗 PML 抗体阴性。该检测的敏感性和特异性分别为 98.9%和 98.7%。
PML 免疫荧光染色是一种快速（<4 小时周转时间）和可靠的一线诊断方法，可促进靶向治疗的启动，特别是在细胞遗传学和分子检测不易获得的临床环境中。
