{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T06:40:25Z","timestamp":1776148825413,"version":"3.50.1"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>\n                    Acute promyelocytic leukemia (APL) is a distinct subtype of acute myeloid leukemia defined by the t(15;17)(q24;q21)-derived\n                    <jats:italic>PML::RARA<\/jats:italic>\n                    fusion. However, a small subset of patients harbor cryptic or atypical\n                    <jats:italic>RARA<\/jats:italic>\n                    rearrangements that escape detection by routine real-time quantitative RT-PCR (qRT-PCR). We report a 34-year-old man presenting typical APL in whom repeated testing for the canonical long, short, and variant\n                    <jats:italic>PML::RARA<\/jats:italic>\n                    transcripts yielded negative results. RNA sequencing subsequently identified a previously unreported in-frame fusion linking\n                    <jats:italic>PML<\/jats:italic>\n                    exon 8 to a 58\u2013base pair\u2013deleted\n                    <jats:italic>RARA<\/jats:italic>\n                    exon 3. The resulting chimeric transcript retained the\n                    <jats:italic>PML<\/jats:italic>\n                    coiled-coil domain as well as the DNA- and ligand-binding domains of\n                    <jats:italic>RARA<\/jats:italic>\n                    , suggesting preserved sensitivity to retinoid-based therapy. Consistent with this prediction, induction therapy with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) resulted in achievement of complete molecular remission. Molecular relapse occurred three months after premature discontinuation of maintenance therapy, underscoring the leukemogenic potential of this novel fusion. This observation expands the molecular spectrum of APL and highlights the potential value of incorporating RNA sequencing into the diagnostic workflow for morphologically suspected but PCR-negative APL.\n                  <\/jats:p>","DOI":"10.3389\/fonc.2026.1784103","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T05:40:20Z","timestamp":1776145220000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A novel PML::RARA fusion in acute promyelocytic leukemia: a case report and literature review"],"prefix":"10.3389","volume":"16","author":[{"given":"Jia-Ping","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Hematology, The Second Clinical Medical College of Jinan University, Shenzhen People\u2019s Hospital","place":["Shenzhen, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun-Jie","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Hematology, Shenzhen People\u2019s Hospital (The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology)","place":["Shenzhen, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Yong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Hematology, Shenzhen People\u2019s Hospital (The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology)","place":["Shenzhen, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Xuan","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Hematology, Shenzhen People\u2019s Hospital (The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology)","place":["Shenzhen, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Ke","sequence":"additional","affiliation":[{"name":"Department of Hematology, Shenzhen People\u2019s Hospital (The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology)","place":["Shenzhen, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji-Hao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Hematology, Shenzhen People\u2019s Hospital (The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology)","place":["Shenzhen, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-Na","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Hematology, Shenzhen People\u2019s Hospital (The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology)","place":["Shenzhen, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1186\/s12885-023-10612-z","article-title":"Acute promyelocytic leukaemia: population-based study of epidemiology and outcome with ATRA and oral-ATO from 1991 to 2021","volume":"23","author":"Gill","year":"2023","journal-title":"BMC Cancer"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a041582","article-title":"Acute promyelocytic leukemia, retinoic acid, and arsenic: A tale of 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