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Published on: August 31, 2016
Prevalence of t(12;21)[ETV6-RUNX1]-positive cells in healthy neonates
Ulrik Lausten-Thomsen1, Hans Ole Madsen, Therese Risom Vestergaard
1Department of Paediatrics, The University Hospital Rigshospitalet, Copenhagen, Denmark.
Insights
The ETV6-RUNX1 fusion gene, linked to childhood leukemia, was investigated in 1417 neonates. Researchers found significantly lower levels of ETV6-RUNX1-positive cells at birth than previously suggested.
Area of Science:
- Hematology
- Oncology
- Genetics
Background:
- The ETV6-RUNX1 fusion gene, resulting from the t(12;21)(p13;q22) chromosomal translocation, is the most frequent genetic abnormality in childhood acute lymphoblastic leukemia (ALL).
- Previous research suggested prenatal initiation and high levels of ETV6-RUNX1-positive cells at birth, potentially detectable via Guthrie cards.
Purpose of the Study:
- To investigate the actual prevalence and levels of ETV6-RUNX1-positive cells in healthy neonates at birth.
- To re-evaluate the frequency of ETV6-RUNX1 transcripts in umbilical cord blood compared to prior estimates.
Main Methods:
- Isolation of mononuclear cells from 1417 umbilical cord blood samples collected within 24 hours of birth.
- Screening for ETV6-RUNX1 transcripts using a sensitive real-time reverse transcription polymerase chain reaction (RT-PCR) assay.
- Confirmatory analyses including specific hybridization, mRNA re-analysis, and flow cytometric sorting of cell subpopulations.
Main Results:
- Initial RT-PCR detected ETV6-RUNX1 transcripts in 14 samples (below 10^-5), with specific hybridization confirming 9 cases.
- Subsequent rigorous analyses, including re-testing stored mRNA and flow cytometry on sorted cell populations (mean 18x10^6 cells), yielded no positive findings.
- The study indicates that the level and/or frequency of ETV6-RUNX1-positive cells at birth is substantially lower than previously reported.
Conclusions:
- The prevalence of ETV6-RUNX1-positive cells in healthy neonates is markedly lower than suggested by earlier studies.
- This finding necessitates a re-evaluation of the role and detection methods for ETV6-RUNX1 in early leukemogenesis.
Abstract:
t(12;21)(p13;q22)[ETV6-RUNX1] is the most common chromosomal translocation in childhood acute lymphoblastic leukemia, and it can often be backtracked to Guthrie cards supporting prenatal initiation and high levels of circulating t(12;21)-positive cells at birth. To explore the prevalence of ETV6-RUNX1-positive cells in healthy neonates, mononuclear cells from 1417 umbilical cord blood samples were isolated within 24 hours from birth and subsequently screened for ETV6-RUNX1 transcripts using a highly sensitive real-time reverse transcription polymerase chain reaction assay. In first-run polymerase chain reaction, 14 samples were positive at levels below 10(-5), of which specific hybridization reflecting the relevant genetic region was positive in 9 cases. Repeated analyses using stored mRNA and flowcytometric sorting of a CD19(+), CD8(+), and CD19(-)/CD8(-) subpopulations from cryopreserved mononuclear cells from the same cord blood samples (mean sorted: 18 × 10(6) cells) revealed no positive findings, which demonstrates that the level and/or frequency of ETV6-RUNX1-positive cells is markedly lower than suggested in previous studies.
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