Korean J Lab Med.  2009 Oct;29(5):379-383. 10.3343/kjlm.2009.29.5.379.

Detection of PML/RARA Rearrangement by Reverse Transcriptase-PCR and Sequencing in a Case of Microgranular Acute Promyelocytic Leukemia Lacking t(15;17) on Karyotype and FISH

  • 1Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea. jyhan@dau.ac.kr
  • 2Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.


We report a case of morphologically microgranular acute promyelocytic leukemia with PML/RARA fusion transcripts demonstrated by reverse transcriptase-PCR and cDNA sequencing, and no PML/RARA fusion detected by karyotype and FISH analyses. Karyotype was 47,XX,+8[19]/46,XX[1]. Although the newer FISH probes provide more accurate detections of t(15;17), it would be necessary to perform other molecular tests to further identify the masked PML/RARA fusions.


Cryptic PML/RARA rearrangement; Acute promyelocytic leukemia; RT-PCR; PML/RARA; Trisomy 8

MeSH Terms

Chromosomes, Human, Pair 15/*genetics
Chromosomes, Human, Pair 17/*genetics
Chromosomes, Human, Pair 8
In Situ Hybridization, Fluorescence/methods
Leukemia, Promyelocytic, Acute/diagnosis/*genetics/pathology
Middle Aged
Oncogene Proteins, Fusion/*genetics
Reverse Transcriptase Polymerase Chain Reaction/*methods
Sequence Analysis, DNA/*methods
*Translocation, Genetic


  • Fig. 1. Abnormal hypogranular or sparsely granular promyelocytes from the peripheral blood smear (A) and bone marrow aspiration smear (B) (Wright-Giemsa stain, ×1,000).

  • Fig. 2. Giemsa-banded karyotype of bone marrow showing a 47,XX,+8. Trisomy 8 (arrow), and intact chromosomes 15 and 17 are observed.

  • Fig. 3. (A) Cohybridization FISH analysis with LSI PML/RARA dual color, dual fusion and chromosome 8 centromeric probes. There are three pink fluorescences on each chromosome 8 centromere, but no PML/RARA fusion signals on metaphase. (B) Cohybridization FISH analysis with LSI RARA dual color, break apart rearrangement and chromosome 8 centromeric probes. There are three chromosomes 8 but no RARA break apart rearrangement signals on metaphase.

  • Fig. 4. RT-PCR for PML/RARA fusion transcripts. S-form (393 bp) PML/RARA chimeric transcripts were amplified. Abbreviation: RT-PCR, reverse transcriptase-PCR.

Cited by  1 articles

핵형분석에서 t(15;17) 결여된 치료관련 급성전골수구성백혈병 1예 보고
Jun Lee, Young-Eun Kim
Lab Med Online. 2021;11(3):211-213.    doi: 10.47429/lmo.2021.11.3.211.


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