INFREQUENT ALTERATIONS OF THE RAR-ALPHA GENE IN ACUTE MYELOGENOUS LEUKEMIAS, RETINOIC ACID-RESISTANT ACUTE PROMYELOCYTIC LEUKEMIAS, MYELODYSPLASTIC SYNDROMES, AND CELL-LINES
R. Morosetti et al., INFREQUENT ALTERATIONS OF THE RAR-ALPHA GENE IN ACUTE MYELOGENOUS LEUKEMIAS, RETINOIC ACID-RESISTANT ACUTE PROMYELOCYTIC LEUKEMIAS, MYELODYSPLASTIC SYNDROMES, AND CELL-LINES, Blood, 87(10), 1996, pp. 4399-4403
Retinoids are important regulators of cell growth and differentiation
in vitro and in vivo and they exert their biologic activities by bindi
ng to nuclear retinoic acid receptors (RARs; alpha, beta, and gamma) a
nd retinoid X receptors (RXRs; alpha, beta, and gamma). All-trans reti
noic acid (RA) induces complete remission in patients with acute promy
elocytic leukemia (APL) presumably by binding directly to RAR alpha of
APL cells. Leukemic blasts from APL patients initially responsive to
RA can become resistant to the agent. HL-60 myeloblasts cultured with
RA have developed mutations of the ligand-binding region of RAR alpha
and have become resistant to RA. Furthermore, insertion of an RAR alph
a with an alteration in the ligand-binding region into normal murine b
one marrow cells can result in growth factor-dependent immortalization
of the early hematopoietic cells. To determine if alterations of the
ligand binding domain of RAR alpha might be involved in several malign
ant hematologic disorders, the mutational status of this region (exons
7, 8, and 9) was examined in 118 samples that included a variety of c
ell lines and fresh cells from patients with myelodysplastic syndromes
(MDS) and acute myeloid leukemias (AML), including 20 APL patients, 5
of whom were resistant to RA and 1 who was refractory to RA at diagno
sis, using polymerase chain reaction-single-strand conformational poly
morphism (PCR-SSCP) analysis and DNA sequencing. In addition, 7 of the
20 APLs were studied for alterations of the other coding exons of the
gene (exons 2 through 6). No mutations of RAR alpha were detected. Al
though the sensitivity of PCR-SSCP analysis is less than 100%, these f
indings suggest that alterations of RAR alpha gene are rare and theref
ore other mechanisms must be involved in the onset of resistance to re
tinoids and in the lack of differentiation in disorders of the myeloid
lineage. (C) 1996 by The American Society of Hematology.