Prognostic Impact Of FLT3-ITD And NPM1Mutations In Acute Myeloid Leukemia

[Background]Acute myeloid leukemia(AML) is a group of highly heterogeneous malignant diseases.Cytogenetic abnormalities and genetic abnormalities are crucial to its pathogenesisand prognosis. In recent years, several important gene mutations have beendiscovered. Their clinical features and prognostic impact have been reported.FLT3-ITD and NPM1mutations are the most common ones. They could be used forrisk stratification and to predict prognostic and therapeutic decisions regardingpatients with AML.[Objective]To study the clinical features and prognostic impact of mutations FLT3-ITD andNPM1in patients with acute myeloid leukemia.[Methods]A total of83patients with AML(non-M3) were collected, which were diagnosedbetween May1,2010and January31,2013in Fujian Medical University UnionHospital. Retrospective analysis were used for clinical features and prognostic impactof mutations FLT3-ITD and NPM1in AML.[Results]Of the83AML patients analyzed,80cases received the testing of FLT3-ITDmutations, and82cases received the testing of NPM1mutations. The prevalence ofFLT3-ITD and NPM1mutations was12.5%(10/80) and13.4%(11/82), respectively.Both FLT3-ITD and NPM1mutations were found in one patient. Patients withFLT3-ITD mutations had higher initial WBC counts, percentage of blasts inperipheral blood, LDH, and CD15-negative. Patients with NPM1mutations hadhigher initial PLT counts, percentage of blasts in bone marrow, CD34-negative, andmore often had a normal karyotype. Single NPM1-mutation predicted a highercomplete remission(CR) rate（P=0.016） and a lower relapse rate（P=0.049）. NPM1 mutations predicted a longer overall survival(OS; P=0.036) and a trend of longerrelapse-free survival (RFS; P=0.078) by univariate analysis, but were not obvious bymultivariate analysis when the entire patient cohort was considered. The clinicalimpact of single FLT3-ITD-mutation on patients’ overall survival, relapse-freesurvival, complete remission rate, and relapse rate could not be observed.[Conclusion]The clinical features are obvious in FLT3-ITD and NPM1mutations. Patients withNPM1mutation have a favorable prognosis. Our present data failed to support theprognostic relevance of FLT3-ITD mutations. The reason may be the small number ofcases and the short follow-up time. It’s necessary to detect FLT3-ITD and NPM1mutations in AML, which could be used for risk stratification and to predictprognostic and therapeutic decisions regarding patients with AML.