Rinaldi Ikhwan, Louisa Melva, Mulya Sari Resti, Arwanih Elly
Division of Hematology and Medical Oncology, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Department of Pharmacology and Therapeutics, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Onco Targets Ther. 2021 Feb 26;14:1479-1486. doi: 10.2147/OTT.S282842. eCollection 2021.
To analyze the association of FLT3-ITD mutation and FLT3 ligand plasma level with one-year survival of Indonesian acute myeloid leukemia (AML) patients.
A prospective cohort study was conducted to determine the association between FLT-3-ITD mutation and FLT3 ligand plasma level with one-year survival of Indonesian AML patients. In the study, a total of 51 AML patients were obtained from two tertiary hospitals in Indonesia from year 2018 to 2020. Inclusion criteria were de novo AML male and female patients aged ≥18 years old. Exclusion criteria were prior myelodysplastic syndrome and patients that refused to participate in the study. FLT3-ITD genotype of patients was then analyzed using PCR method while FLT3 ligand plasma level was measured using ELISA method. Patients were then followed-up for 1 year or until death occurred with survival as the measured outcome. Association between independent and dependent variable were analyzed by cox regression proportional hazard.
Eleven patients (21.5%) in this study had FLT3-ITD mutation. The median age of AML patients was 45 (18-71) years, and the median blast percentage was 50% (5-87%). After one-year follow-up, 33 (64.7%) patients had died. The median survival of AML patients was 6 months. Univariate analysis showed no association between FLT3-ITD mutation status (HR: 1.051 ; 95% CI: 0.483-2.286; P: 0.901) and FLT3 ligand plasma level (HR: 0.798; 95% CI: 0.347-1.837; p= 0.596), and age (HR: 1.283; 95% CI: 0.575-2.862; p= 0.542) with one-year survival of AML patients, but multivariate analysis showed association between GFR with one-year survival of AML patients in this cohort (HR: 4.053; 95% CI: 1.469-11.183; p= 0.007).
One-year survival of AML patients in Indonesia is not affected by FLT3-ITD mutation and FLT3 ligand plasma level. However, GFR showed association with one-year survival of AML patient in this cohort study.
分析FLT3-ITD突变及FLT3配体血浆水平与印度尼西亚急性髓系白血病（AML）患者一年生存率的相关性。
开展一项前瞻性队列研究，以确定FLT-3-ITD突变及FLT3配体血浆水平与印度尼西亚AML患者一年生存率之间的关联。该研究中，2018年至2020年期间从印度尼西亚两家三级医院共纳入51例AML患者。纳入标准为年龄≥18岁的初发AML男性和女性患者。排除标准为既往有骨髓增生异常综合征以及拒绝参与本研究的患者。随后采用PCR方法分析患者的FLT3-ITD基因型，同时采用ELISA方法测定FLT3配体血浆水平。然后对患者进行为期1年的随访，或以生存情况作为测量指标直至患者死亡。采用Cox回归比例风险模型分析自变量与因变量之间的关联。
本研究中有11例患者（21.5%）发生FLT3-ITD突变。AML患者的中位年龄为45（18-71）岁，中位原始细胞百分比为50%（5-87%）。经过一年的随访，33例（64.7%）患者死亡。AML患者的中位生存期为6个月。单因素分析显示，FLT3-ITD突变状态（HR：1.051；95%CI：0.483-2.286；P：0.901）、FLT3配体血浆水平（HR：0.798；95%CI：0.347-1.837；p=0.596）以及年龄（HR：1.283；95%CI：0.575-2.862；p=0.542）与AML患者的一年生存率无相关性，但多因素分析显示该队列中肾小球滤过率（GFR）与AML患者的一年生存率存在相关性（HR：4.053；95%CI：1.469-11.183；p=0.007）。
印度尼西亚AML患者的一年生存率不受FLT3-ITD突变及FLT3配体血浆水平的影响。然而，在本队列研究中GFR与AML患者的一年生存率存在相关性。
