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PACLseq: A Standalone Diagnostic Method for Ph-Like Acute Lymphoblastic Leukemia Using Nanopore Sequencing.

Hang Zhang1, Huan Yu2, Yanmei Chen2

  • 1Department of Hematology, Institute of Hematology West China Hospital of Sichuan University Chengdu Sichuan China.

Medcomm
|September 19, 2025
PubMed
Summary

A new method, Partial Anchored Capture and Long-Read Sequencing (PACLseq), rapidly and accurately detects Philadelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL) fusion genes. This breakthrough improves diagnostic efficiency and patient outcomes for Ph-like ALL.

Keywords:
Philadelphia chromosome–like acute lymphoblastic leukemiaTarget transcriptome sequencinggene fusionlong‐read sequencing

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Area of Science:

  • Genomics
  • Molecular Diagnostics
  • Oncology

Background:

  • Philadelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL) diagnosis relies on detecting specific fusion genes.
  • Current diagnostic methods for Ph-like ALL are time-consuming, costly, and struggle with degraded samples.

Purpose of the Study:

  • To develop and validate a rapid, cost-effective, and accurate method for detecting Ph-like ALL-related fusion genes.
  • To address the limitations of existing diagnostic workflows for Ph-like ALL.

Main Methods:

  • Introduction of Partial Anchored Capture and Long-Read Sequencing (PACLseq), a nanopore-sequencing-based approach.
  • Design of a targeted gene panel for Ph-like ALL, including key genes like ABL1, JAK2, and CRLF2.
  • Validation of PACLseq on 47 clinical samples, including degraded RNA specimens.

Main Results:

  • PACLseq demonstrated 93.3% sensitivity and 100% specificity in degraded RNA samples (RIN > 3).
  • The method successfully detected fusion genes in low-quality RNA samples (RIN ≤ 3) with fragmented transcripts.
  • PACLseq provides results in 3 days, a significant reduction from 7-14 days, with 50% cost savings.

Conclusions:

  • PACLseq offers a rapid, accurate, and cost-effective solution for Ph-like ALL fusion gene detection.
  • The technology enhances diagnostic efficiency, enabling timely treatment decisions for Ph-like ALL patients.
  • PACLseq has the potential to significantly improve patient management and outcomes in Ph-like ALL.