Comparison Of Molecular Biology And Immunological Characteristics And Clinical Efficacy Of The Patients In Acute Myelogenous Leukemia With Or Without FLT3-ITD Gene Mutation

Objective Acute myeloid leukemia is the most important part of hematologic malignancies, the incidence rate showed an upward trend. Unfortunately, its pathogenesis is not yet fully understood, mainly from cytogenetics, molecular biology and immunology performance to learn it,so that classification criteria, treatment methods and prognosis indicators are also constantly correct. Cytogenetics were identified as independent prognostic indicators,but large amounts of data show that about45%of AML patients with normal karyotype, prognosis evaluation of them rely on molecular biology features. Therefore, the significance of gene’s detection is very clearly, especially the early warning meaning to patients who recived complete remission.Today’s clinical test results showed: FLT3(FMS‐like receptor tyrosine kinase3) and NPM1(Nucleophosmin) are the most frequent mutated gene in AML.FLT3, because of its negative effect on patients,gains more attentions from researchers.However, the comparative analysis of clinical and laboratory characteristics, Clinical efficacy and prognosis is still wanting.This paper summarized the clinical features, immunology, cytogenetics, molecular biology, therapeutic effect and prognosis of newly diagnosed patients with or without FLT3‐ITD mutation, to explore the gene systematically.Methods Retrospective analysis of93novol AML patients, aged from10to66years, were joined in this study in which21patients who had FLT3‐ITD gene expression were assined to FLT3‐ITD_group, and other72patients who had no FLT3‐ITD gene expression were assined to control_group. Cytogenetic studies and the gene mutatations of FLT3‐ ITD，NPM1and others were analyzed.Results Among the93patients,22.58%of them expressed FLT3‐ITD gene. The rate of higher white blood cells (>100×10~9/L) and bleeding in FLT3‐ITD+AML group were significant higher than that in the FLT3‐ITD‐group (P=0.04；P=0.01). However, there were no statistically significant differences in age, gender, immunophenotyping and cytogenetic (P>0.05) in the two groups.The complete remission (CR) rate was28.57%in the FLT3‐ITD+AML group which was lower than that in the FLT3‐ITD‐AML group (55.56%, P=0.013). The2years event‐free survival of patients was29.2%in the FLT3‐ITD+AML which was lower than that in the FLT3‐ITD‐AML (37.7%; p=0.04).Meanwhile,33.3%of the patients in the FLT3‐ITD+AML were associated with NPM1gene expression and all of them got no complete remission, however, only1.39%of the patients expressed NPM1gene in the control group and50%of them got complete remission（p=0.022）.Conclusion AML Patients with FLT3‐ITD~+were easily associated with high WBC counts, bleeding, lower CR rate and poor event‐free survival, suggested a poor group. Patients with FLT3and NPM1combined expression worse clinical effect.