| Objective:To investigate and discuss the expression and clinical Significance of FLT3 and NPM1 in patients with acute myeloide leukemia(AML).Methods:The levels of FLT3 and NPM1 were measured by semiquantitative reverse transcription polymerase chain reaction(RT-PCR)method in 58AML patients which (included 38 patients with de novo acute myeloid leukemia,15 patients in complete remission).Then analysis the relationship of the levels of FLT3 and NPM1 and the respone to treatment, patients'sex, age, peripheral blood cells, blast cells of bone marrow and Immunophenotypic.Result:1.The positive rate of FLT3 and NPM1 expression in newly diagnosed of AML was 86.8% and 73.8%, both refractory and relapsed groups positive rates were 100%, the positive rates of FLT3 and NPM1 in CR group were 20% and 66.7%. The positive rates of control group were 33.3% and 60%. Newly diagnosed group and the group refractory and relapsed FLT3-positive was significantly higher than CR group and the control group, (P>0.05); the positive rate of NPM1 was not significant between the four groups, (P>0.05)2. FLT3 expression levels in Group of patients with Newly diagnosed AM L, refractory and recurrent group, CR group and control group were 0.3312(0～1.0628),0.7065 (0.3471～1.0980),0 (0-0.3586) and 0 (0～0.3105).Newly diag nosed group, refractory relapse was significantly higher than CR group and th e normal control group (P<0.05); refractory and relapsed group was higher th an untreated group (P<0.05). NPM1 expression levels in Newly diagnosed gro up, refractory and recurrent group, CR group and control group were 0.5410(0～1.1468),0.7988(0.6581～1.2548),0.4836(0-0.9141) and 0.3718(0.4581～1.2548). Newly diagnosed and refractory relapse group was higher than CR group an d the control group (P<0.05), refractory and recurrent group than in Newly di agnosed patients (P<0.05). 3.There was no relationship in expression level of FLT3 and NPM1 mRNA among gender, age, and Immunophenotypic. the expression level of FLT3 and NPM1 mRNA markedly correlated with the number of white blood cell and bone marrow blast cell.4.FLT3 and NPM1 high expression and low expression group and the treatment group in Newly diagnosed AML patients did not express rates were 37.5% and 63.1%,92% and 88.9% and 100% and 100%. Combined with high expression efficiency of treatment was only 16.7%. FLT3 and/or NPM1 high expression efficiency of treatment was significantly lower than the low expression group and non-expression group (P<0.05).5.FLT3 and NPM1 effective group treatment expression levels In Newly diagnosed AML patients were 0.3123 (0-0.6287) and 0.4001(0.9426), no effective group expression of FLT3 and NPM1 were 0.7754 (0.3287～1.0215) and 0.8708(0.4732～1.1468), no effective group of FLT3 and NPM1 expression was significantly higher than the effective group (P<0.05)6.The expression level of FLT3 and NPM1 were dynamic monitoring change of FLT3 and NPM1 leves after treatment in 28 patients with Newly diagnosed AML, the results for CR 19 cases, FLT3 and NPM1 expression were 0.4117 (0-0.6419)∞0(0-0.2128), P<0.05 and 0.4810 (0-0.9417)∞0.4124 (0-0.7381), P>0.05. FLT3 and NPMl expression levels in NR effective group of 3 patients,were 0.8912 (0.8712～1.0215)∞0.9158 (0.4453～0.9476), P> 0.05 and 1.0973 (0.9203～1.1468)∞0.8556 (0.6418～1.1038), P>0.05.4 patients with refractory Before and after treatment in patients with recurrent FLT3 and NPM1 expression does not change much. Continuous complete remission after treatment of patients with FLT3 and NPM1 expression level of were stability.Conclusion:1.The Dositive rate of FLT3 and NPM1 with AML patients is 86.8% and 73.8%.2.There is a overexpression phenomenon of FLT3 and NPM1 in AML. The overexpression phenomenon is related with disease states.3.The expression level of FLT3 and NPM1 mRNA markedly correlated with the number of white blood cell and bone marrow blast cell. 4. AML with high expression of FLT3 and/or NPM1 have poor clinical efficacy, CR rate is low, CR time is short, it easy to relapse, quantitative analysis of the expression level of FLT3 and NPM1 can be used as indicators of prognostic stratification in patients with AML, FLT3 and NPM1 were high expression may Classified as high-risk group, indicator of poor prognosis. There was a close correlation between the concentration of FLT3 or NPM1 overexpression with the therapeutic effect and prognosis.5.Dynamieally detecting the change of FLT3 and NPM1 can predict relapse MRD monitoring may become one of the indicatorsand direct us to prevent and cure relapse. |
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