What is APL?
Rare, aggressive subtype of Acute Myeloid Leukemia (AML) (accounts for 10–15% of AML cases).
Caused by fusion of PML and RARA genes, leading to:
Low white blood cells → risk of infections.
Low platelets → risk of severe internal bleeding (lungs, brain).
Rapidly fatal if untreated, but highly curable with early diagnosis and treatment.
Epidemiology
Median diagnosis age: 34 years.
Male : Female ratio = 1.5:1.
At Tata Memorial Hospital, ~50–60 new APL cases reported annually.
Problems with Existing Diagnostic Methods
Slow results → delays life-saving treatment.
Require:
Expensive machines.
Highly trained specialists.
Advanced labs.
Not suitable for rural areas or resource-limited settings.
RAPID-CRISPR – New Diagnostic Test Developed by ACTREC
Developed at: Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Mumbai.
Backed by: Department of Atomic Energy (DAE).
Published in: Blood Advances journal.
Full Form: Redefined APL IDentification.
Key Features
Uses CRISPR technology for molecular diagnosis (not editing).
Works directly on peripheral blood sample (sufficient in 80% of cases).
Uses a lateral flow strip (like a COVID-19/home pregnancy test).
Time for diagnosis: Under 3 hours.
Detects PML-RARA gene fusion accurately.
Advantages
Near 100% sensitivity and specificity.
Detects even single copies of the mutation (10x more sensitive than RQ-PCR).
No need for genetic material amplification, complex labs, or advanced skills.
Affordable, accessible, ideal for rural and small hospitals.
Technical Details
Uses three test strips for detecting three isoforms:
bcr1, bcr2, and bcr3 (common mutations of PML-RARA).
Future goal: Single-strip detection of all isoforms in one-tube reaction.
Clinical Evaluation
Tested on 134 clinical samples.
Detected APL accurately in 100% of cases.
Effective even with low white blood cell counts (in such cases, bone marrow sample preferred).
Importance for India and Developing Countries
Can bridge diagnostic gap in under-resourced areas.
Reduces delay → can save lives by enabling early treatment.
Potential for widespread use in public hospitals and at-home diagnosis in the future.
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