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Standardization of BCR-ABL1 p210 Monitoring: From Nested to Digital PCR
Aleksandar Jovanovski1, Jessica Petiti1, Emilia Giugliano2
1Department of Clinical and Biological Sciences, University of Turin, 10043 Turin, Italy.
Abstract:
The introduction of tyrosine kinase inhibitors in 2001 as a targeted anticancer therapy has significantly improved the quality of life and survival of patients with chronic myeloid leukemia. At the same time, with the introduction of tyrosine kinase inhibitors, the need for precise monitoring of the molecular response to therapy has emerged. Starting with a qualitative polymerase chain reaction, followed by the introduction of a quantitative polymerase chain reaction to determine the exact quantity of the transcript of interest-p210 BCR-ABL1, molecular monitoring in patients with chronic myeloid leukemia was internationally standardized. This enabled precise monitoring of the therapeutic response, unification of therapeutic protocols, and comparison of results between different laboratories. This review aims to summarize the steps in the diagnosis and molecular monitoring of p210 BCR-ABL1, as well as to consider the possible future application of a more sophisticated method such as digital polymerase chain reaction.
Insights
Tyrosine kinase inhibitors have transformed chronic myeloid leukemia (CML) treatment, necessitating precise molecular monitoring. Quantitative polymerase chain reaction (qPCR) for p210 BCR-ABL1 transcript levels standardized CML patient monitoring.
Area of Science:
- Oncology
- Molecular Biology
- Hematology
Background:
- Tyrosine kinase inhibitors (TKIs) revolutionized chronic myeloid leukemia (CML) treatment since 2001, improving patient survival and quality of life.
- The advent of TKIs created a critical need for accurate molecular monitoring of therapeutic response in CML patients.
- Early monitoring methods evolved from qualitative to quantitative polymerase chain reaction (qPCR) for precise measurement of p210 BCR-ABL1 transcripts.
Purpose of the Study:
- To review the diagnostic and molecular monitoring procedures for p210 BCR-ABL1 in chronic myeloid leukemia.
- To highlight the standardization of molecular monitoring through quantitative polymerase chain reaction (qPCR).
- To explore the potential future use of advanced techniques like digital polymerase chain reaction (dPCR).
Main Methods:
- Review of diagnostic and molecular monitoring techniques for p210 BCR-ABL1 in CML.
- Discussion of the transition from qualitative to quantitative polymerase chain reaction (qPCR) for transcript quantification.
- Consideration of digital polymerase chain reaction (dPCR) as a future monitoring tool.
Main Results:
- Quantitative polymerase chain reaction (qPCR) enabled precise monitoring of p210 BCR-ABL1 transcript levels in CML patients.
- International standardization of molecular monitoring facilitated unified therapeutic protocols and inter-laboratory result comparison.
- The evolution of monitoring techniques has enhanced the management of CML patients undergoing targeted therapy.
Conclusions:
- Molecular monitoring, particularly using qPCR for p210 BCR-ABL1, is essential for effective CML management with TKIs.
- Standardization has improved the reliability and comparability of CML patient monitoring globally.
- Digital polymerase chain reaction (dPCR) represents a promising advancement for future, more sensitive molecular monitoring in CML.
