Tandem duplication PCR: An ultrasensitive assay for the detection of internal tandem duplications of the FLT3 Gene
Journal
Diagnostic Molecular Pathology
Journal Volume
22
Journal Issue
3
Pages
149-155
Date Issued
2013
Author(s)
Lin M.-T.
Beierl K.
Hsieh A.
Thiess M.
Chase N.
Stafford A.
Levis M.J.
Eshleman J.R.
Gocke C.D.
Abstract
Internal tandem duplication (ITD) mutations of the FLT3 gene have been associated with a poor prognosis in acute myeloid leukemia. Detection of ITD-positive minor clones at the initial diagnosis and during the minimal residual disease stage may be essential. We previously designed a delta-PCR strategy to improve the sensitivity to 0.1% ITD-positive leukemia cells and showed that minor mutants with an allele burden of <1% can be clinically significant. In this study, we report on tandem duplication PCR (TD-PCR), a modified inverse PCR assay, and demonstrate a limit of detection of a few molecules of ITD mutants. The TD-PCR was initially designed to confirm ITD mutation of an amplicon, which was undetectable by capillary electrophoresis and was incidentally isolated by a molecular fraction collecting tool. Subsequently, TD-PCR detected ITD mutation in 2 of 77 patients previously reported as negative for ITD mutation by a standard PCR assay. TD-PCR can also potentially be applied to monitor minimal residual disease with high analytic sensitivity in a portion of ITD-positive acute myeloid leukemia patients. Further studies using TD-PCR to detect ITD mutants at diagnosis may clarify the clinical significance of those ITD mutants with extremely low allele burden. Copyright ? 2013 by Lippincott Williams & Wilkins.
Subjects
acute myeloid leukemia; FLT3; internal tandem duplication; minimal residual disease; tandem duplication PCR
SDGs
Other Subjects
acute granulocytic leukemia; article; cancer prognosis; controlled study; FLT3 gene; gene; gene duplication; gene mutation; genetic analysis; human; human cell; human tissue; leukemia cell; limit of detection; major clinical study; polymerase chain reaction; priority journal; tandem repeat
Type
journal article