Abstract
Objective To analyze the clinical features and prognosis of acute myeloid leukemia(AML)patients with FLT3-ITD mutation. Methods Clinical features and therapeutic effect were retrospectively analyzed in 39 AML patients with FLT3-ITD mutation from June 2011 to March 2014. Results AML patients with FLT3-ITD mutations were identified in 11.6 % patients(39/337). The mutation was most frequently found in patients with M5 subtype(43.6 %, 17/39), secondly in patients with M2 type(28.2 %, 11/39). The mean of the peripheral WBC was 88.63×109/L, and there were 30.8 %(12/39)patients with WBC > 100×109/L. Mean of blast cell in bone marrow(BM)was 82.53 %, and there were 84.6 %(33/39)patients with more over 50 %. In addition, among 37 patients, there were 13 patients with extramedullary infiltration, 17 patients with normal karyotype, 9 patients with abnormal karyotype, 13 patients with NPM1 gene mutation, 2 patients with KIT gene mutation, 3 patients with DNMT3 gene mutation. After treatment, 43.2 %(16/37)patients achieved complete remission(CR)after first induced therapy, and 10.8 %(4/37)patients achieved CR after second induced therapy. The death rate related to induced therapy was 21.6 %(8/37). The median follow-up period was 12 months. Relapse rate of the 20 patients after CR was 50.0 %(10/20), relapse free survival(RFS)was 45.0 %(9/20), and overall survival(OS)and RFS of transplantation group were higher than those of chemotherapy group(P= 0.004, 0.020). Conclusion AML patients with FLT3-ITD mutation have the characteristics of higher peripheral WBC, higher blast cells in BM and accompanying with M5 subtype. Allo-HSCT can significantly improve OS and RFS in these patients. Key words: Leukemia, myeloid, acute; FLT3-ITD mutation; Prognosis
Published Version
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