BACKGROUND: Despite the efficacy of the BCR-ABL tyrosine kinase inhibitor Imatinib mesylate for the treatment of chronic myeloid leukemia (CML), resistance has been observed in a proportion of cases, especially those with advanced stages of the disease. Point mutations within the ABL kinase domain are emerging as the most frequent mechanism for reactivation of kinase activity within the leukemic clone. METHODS: We developed a denaturing-HPLC (D-HPLC)-based assay for screening for ABL point mutations. For each sample, two partially overlapping fragments of 393 and 482 bp corresponding to the kinase domain were amplified by nested reverse transcription-PCR and analyzed under selected temperature and acetonitrile gradient conditions. Fifty-one bone marrow and/or peripheral blood specimens from 27 CML patients who showed cytogenetic resistance to Imatinib were screened in parallel by D-HPLC and by direct sequencing. RESULTS: In 12 of 27 (44%) patients, D-HPLC showed an abnormal elution profile suggesting the presence of a nucleotide change. Direct sequencing confirmed the presence of a point mutation in all cases. Conversely, all samples scored as wild type by D-HPLC showed no evidence of mutations by direct sequencing. In two cases, novel amino acid substitutions at codons already known for being hot-spots of mutation were identified (F311I and E355D). CONCLUSIONS: The proposed D-HPLC-based assay is highly specific and at least as sensitive as sequencing; with respect to the latter, it provides a much faster and less expensive semiautomated system for mutational screening. It may therefore potentially be a valuable tool for regular, large-scale testing of patients undergoing Imatinib treatment.
BACKGROUND: Despite the efficacy of the BCR-ABL tyrosine kinase inhibitor Imatinib mesylate for the treatment of chronic myeloid leukemia (CML), resistance has been observed in a proportion of cases, especially those with advanced stages of the disease. Point mutations within the ABL kinase domain are emerging as the most frequent mechanism for reactivation of kinase activity within the leukemic clone. METHODS: We developed a denaturing-HPLC (D-HPLC)-based assay for screening for ABL point mutations. For each sample, two partially overlapping fragments of 393 and 482 bp corresponding to the kinase domain were amplified by nested reverse transcription-PCR and analyzed under selected temperature and acetonitrile gradient conditions. Fifty-one bone marrow and/or peripheral blood specimens from 27 CMLpatients who showed cytogenetic resistance to Imatinib were screened in parallel by D-HPLC and by direct sequencing. RESULTS: In 12 of 27 (44%) patients, D-HPLC showed an abnormal elution profile suggesting the presence of a nucleotide change. Direct sequencing confirmed the presence of a point mutation in all cases. Conversely, all samples scored as wild type by D-HPLC showed no evidence of mutations by direct sequencing. In two cases, novel amino acid substitutions at codons already known for being hot-spots of mutation were identified (F311I and E355D). CONCLUSIONS: The proposed D-HPLC-based assay is highly specific and at least as sensitive as sequencing; with respect to the latter, it provides a much faster and less expensive semiautomated system for mutational screening. It may therefore potentially be a valuable tool for regular, large-scale testing of patients undergoing Imatinib treatment.
Authors: Franz X Gruber; Tuija Lundán; Rasmus Goll; Aleksandra Silye; Ingvild Mikkola; Ole Petter Rekvig; Sakari Knuutila; Kari Remes; Tobias Gedde-Dahl; Kimmo Porkka; Henrik Hjorth-Hansen Journal: Med Oncol Date: 2011-01-08 Impact factor: 3.064
Authors: Rebecca DeBoer; Gregory Koval; Flora Mulkey; Meir Wetzler; Steven Devine; Guido Marcucci; Richard M Stone; Richard A Larson; Clara D Bloomfield; Susan Geyer; Charles G Mullighan; Wendy Stock Journal: Leuk Lymphoma Date: 2016-02-18
Authors: Meir Wetzler; Dorothy Watson; Wendy Stock; Gregory Koval; Flora A Mulkey; Eva E Hoke; John M McCarty; William G Blum; Bayard L Powell; Guido Marcucci; Clara D Bloomfield; Charles A Linker; Richard A Larson Journal: Haematologica Date: 2013-09-27 Impact factor: 9.941