What is APL?
Acute Promyelocytic Leukemia (APL) is a rare and aggressive subtype of Acute Myeloid Leukemia (AML). It is caused by the fusion of two genes, PML and RARA, leading to impaired white blood cell and platelet production. This condition causes life-threatening internal bleeding, especially in organs like the lungs and brain, making rapid diagnosis and treatment crucial.
APL Fast Facts:
- Accounts for 10–15% of AML cases
- Median diagnosis age: 34 years
- Male-to-female ratio: 1.5:1
- Highly curable if treated promptly
Challenge in Current Diagnostics
Existing diagnostic methods:
- Are slow, often delaying life-saving treatment
- Require specialised laboratories, expensive equipment, and skilled professionals
- Are inaccessible in rural, under-resourced, or developing regions
The RAPID-CRISPR Breakthrough
Developed at: ACTREC, Tata Memorial Hospital, Mumbai
Published in: Blood Advances
Supported by: Department of Atomic Energy
Key Highlights:
- RAPID = Redefined APL Identification
- Powered by CRISPR-based molecular diagnostics, not gene editing
- Detects the PML-RARA gene mutation with near 100% sensitivity and specificity
- Result time: Under 3 hours
- Cost-effective and equipment-free
- Uses a simple lateral flow strip, like a home pregnancy test
How It Works
- A sample of peripheral blood (sufficient in 80% of cases) or bone marrow is collected.
- The RAPID-CRISPR reagent is added to detect and cut the mutated gene.
- This action triggers a signal visible on a strip-based test, enabling fast clinical decisions.
Superior Sensitivity & Simplicity
- Detects even a single copy of the PML-RARA gene
- 10x more sensitive than gold-standard RQ-PCR
- No need for gene extraction or amplification
- No false positives or negatives recorded in 134 clinical trials
Transforming Cancer Diagnosis in Low-Resource Settings
- Designed to work without complex labs or high-end machines
- Makes early diagnosis possible in rural and underfunded hospitals
- Potential game-changer for developing countries where delays cost lives
Next Steps and Future Potential
- Currently detects all three PML-RARA isoforms (bcr1, bcr2, bcr3) using three strips
- Future goal: Single-strip, single-tube test
- Long-term vision: At-home testing solutions for ultra-early detection
TH
