Zulfiqar Maria, Ali Natasha, Shaikh Usman, Jehanzeb Hamzah, Arif Salman, Khan Zurrya Fasih, Saeed Nabiha, Ansar Zeeshan
Department of Oncology, Aga Khan University, Karachi, Pakistan.
Department of Pathology and Laboratory Medicine/Oncology, Aga Khan University, Karachi, Pakistan.
J Cancer Allied Spec. 2023 Aug 13;9(2):553. doi: 10.37029/jcas.v9i2.553. eCollection 2023.
Molecular genetic abnormalities in acute myeloid leukaemia (AML) are essential for disease diagnosis and determining prognosis and clinical course. Mutations in FLT3 and nucleophosmin (NPM) genes are the most frequent genetic abnormalities, which are also known to impact disease outcomes. FLT3 mutations have been identified in approximately 30% of AML patients and are associated with poor prognoses. This study aimed to determine the response to induction chemotherapy, overall survival (OS) and relapse rate (RR) in patients with FLT3-positive AML.
In this study, a retrospective analysis was performed of 75 newly diagnosed patients with AML registered between January 2015 and July 2022. Patient demographics and clinical-haematological parameters were noted and molecular analysis for FLT3 ITD/TKD and NPM mutations was performed. All the patients received standard induction chemotherapy and their response to treatment, OS and RR were assessed.
A total of 75 cases of AML were analysed. The mean age of the sample was 34.9 years, of which 65.3% were males and 34.7% were females. The patients were stratified into two groups: Those who were positive for FLT3 while negative for NPM (FLT3+/NPM-), representing 17.3% and those who were negative for both FLT3 and NPM (FLT3-/NPM-), representing 82.7% of cases. On day 28 post-induction, the complete remission rate was 69.2% in the FLT3 positive group and 77.4% in the FLT3 negative group. In the FLT3+/NPM- group, 55.6% of cases who were in remission at day 28 subsequently relapsed, compared to 50.0% of FLT3-/NPM- cases. The overall median survival time for the cohort and FLT3+ group was 1467 days, while that of the FLT3-group could not be estimated due to the very high survival rate.
No significant differences in outcomes were observed in patients who were FLT3 positive compared to those who were FLT3 negative.
急性髓系白血病（AML）中的分子遗传异常对于疾病诊断、判断预后和临床病程至关重要。FMS样酪氨酸激酶3（FLT3）和核仁磷酸蛋白（NPM）基因的突变是最常见的遗传异常，已知它们也会影响疾病转归。约30%的AML患者中已检测到FLT3突变，且这些患者预后较差。本研究旨在确定FLT3阳性AML患者对诱导化疗的反应、总生存期（OS）和复发率（RR）。
本研究对2015年1月至2022年7月登记的75例新诊断AML患者进行了回顾性分析。记录患者的人口统计学和临床血液学参数，并对FLT3内部串联重复/酪氨酸激酶结构域（ITD/TKD）和NPM突变进行分子分析。所有患者均接受标准诱导化疗，并评估其治疗反应、OS和RR。
共分析了75例AML病例。样本的平均年龄为34.9岁，其中男性占65.3%，女性占34.7%。患者被分为两组：FLT3阳性而NPM阴性（FLT3+/NPM-）的患者占17.3%，FLT3和NPM均阴性（FLT3-/NPM-）的患者占82.7%。诱导后第28天，FLT3阳性组的完全缓解率为69.2%，FLT3阴性组为77.4%。在FLT3+/NPM-组中，诱导后第28天缓解的病例中有55.6%随后复发，而FLT3-/NPM-组为50.0%。该队列和FLT3+组的总中位生存时间为1467天，而FLT3-组由于生存率非常高，无法估计中位生存时间。
与FLT3阴性患者相比，FLT3阳性患者的预后未观察到显著差异。
