CHROMOSOMAL TRANSLOCATION T(15-17) IN HUMAN ACUTE PROMYELOCYTIC LEUKEMIA FUSES RAR-ALPHA WITH A NOVEL PUTATIVE TRANSCRIPTION FACTOR, PML

A unique mRNA produced in leukemic cells from a t(15; 17) acute promyelocytic leukemia (APL) patient encodes a fusion protein between the retinoic acid receptor-alpha (RAR-alpha) and a myeloid gene product called PML. PML contains a cysteine-rich region present in a new family of apparent DNA-binding proteins that includes a regulator of the interleukin-2 receptor gene (Rpt-1) and the recombination-activating gene product (RAG-1). Accordingly, PML may represent a novel transcription factor or recombinase. The aberrant PML-RAR fusion product, while typically retinoic acid responsive, displays both cell type- and promoter-specific differences from the wild-type RAR-alpha. Because patients with APL can be induced into remission with high dose RA therapy, we propose that the nonliganded PML-RAR protein is a new class of dominant negative oncogene product. Treatment with RA would not only relieve this inhibition, but the activated PML-RAR protein may actually promote myelocyte differentiation.