Division of Laboratory Haematology, Vancouver General Hospital, Vancouver, British Columbia, Canada.
Clin Lymphoma Myeloma Leuk. 2012 Aug;12(4):274-9. doi: 10.1016/j.clml.2012.01.003. Epub 2012 Apr 4.
In 83 patients with cytogenetically normal acute myeloid leukemia (CN-AML), those with NPM1 and wild-type FLT3 (FLT3-wt) mutation and their poor prognostic combination had distinctive flow cytometric findings: CN-AML with a mutation of NPM1 (NPMI-Mt) were CD34(-), CD14(-), and CD2pos and CD4; those with FLT3-internal tandem duplications (ITD) were CD56pos, those with NPM1-Mt and FLT3-wt were CD34(-) and CD56(-); and those with poor prognostic combination NPM1-wt and FLT3-ITD were CD34pos and TdTpos.
We retrospectively correlated NPM1 and FLT3 mutation status with flow cytometric profile of leukemic blasts in 83 adult patients with cytogenetically normal acute myeloid leukemia (CN-AML).
Mutation of the NPM1 gene (NPM1.mt) was found in 39 (47%) of 83 patients, and internal tandem duplication (ITD) of the FLT3 gene (FLT3-ITD) was seen in 38 (46%) of 83 patients. Patients with CN-AML and with NPM1.mt were less likely to express CD34 (33% vs. 93%; 2P = .0001), CD2 (0% vs. 14%; 2P = .0187), and CD14 (6% vs. 22%, 2P = .0476), and were more likely to express CD4 (65.5% vs. 37%; 2P = .0367) and CD19 (49% vs. 27%; 2P = .0506). The patients with CN-AML and with FLT3-ITD were more likely to express CD56 (47% vs. 23%; 2P = .0393). Moreover, patients with favorable prognostic combination of NPM1.mt and wild-type (wt) FLT3 (n = 18) were less likely to express CD34 (33% vs. 74% all others; 2P = .0021) and CD56 (6% vs. 37% all others; 2P = .0072). The group with an unfavorable prognostic combination of NPM1-wt and FLT3-ITD (n = 17) were more likely to express CD34 (88% vs. 45% all others; 2P = .0011) and TdT (40% vs. 2% all others; 2P = .0054).
In patients with CN-AML, characteristic flow cytometric profile is associated with NPM1 and FLT3 mutation status.
在 83 例细胞遗传学正常的急性髓细胞白血病（CN-AML）患者中，那些具有 NPM1 和野生型 FLT3（FLT3-wt）突变及其不良预后组合的患者具有独特的流式细胞术发现：具有 NPM1 突变（NPMI-Mt）的 CN-AML 为 CD34（-），CD14（-）和 CD2 阳性和 CD4；那些具有 FLT3 内部串联重复（ITD）的患者为 CD56（+），那些具有 NPM1-Mt 和 FLT3-wt 的患者为 CD34（-）和 CD56（-）；而那些具有不良预后组合 NPM1-wt 和 FLT3-ITD 的患者为 CD34（+）和 TdT（+）。
我们回顾性地将 NPM1 和 FLT3 突变状态与 83 例细胞遗传学正常的急性髓细胞白血病（CN-AML）成人患者的白血病细胞的流式细胞术特征相关联。
在 83 例患者中发现 NPM1 基因（NPM1.mt）突变 39 例（47%），FLT3 基因（FLT3-ITD）内部串联重复 38 例（46%）。患有 CN-AML 和 NPM1.mt 的患者不太可能表达 CD34（33%对 93%；2P =.0001），CD2（0%对 14%；2P =.0187）和 CD14（6%对 22%，2P =.0476），并且更有可能表达 CD4（65.5%对 37%；2P =.0367）和 CD19（49%对 27%；2P =.0506）。患有 CN-AML 和 FLT3-ITD 的患者更可能表达 CD56（47%对 23%；2P =.0393）。此外，具有 NPM1.mt 和野生型（wt）FLT3 有利预后组合的患者（n = 18）不太可能表达 CD34（33%对 74%；2P =.0021）和 CD56（6%对 37%；2P =.0072）。具有 NPM1-wt 和 FLT3-ITD 不良预后组合的组（n = 17）更可能表达 CD34（88%对 45%；2P =.0011）和 TdT（40%对 2%；2P =.0054）。
在患有 CN-AML 的患者中，特征性流式细胞术特征与 NPM1 和 FLT3 突变状态相关。
