Detect The Mutation Of FLT3 Gene And Analysis Of Clinical Features In Neoplastic Hematologic

Objective Through the analysis of gene mutation, this paper discusses FLT3-ITD gene mutation rate and distribution in Chinese patients with hematological malignancies, and analyze the clinical features, prognosis, and analyze the correlation between genetic mutations.Method Collect in April 2013-May 2014 in the First Affiliated Hospital of Kunming Medical University from Department of Hematology in 304 cases of different types of blood cancer patients and 10 cases of non malignant tumor patients with bone marrow blood fluid samples. Adopt the method of PCR combined with agarose gel electrophoresis to detect the FLT3 gene in patients with hematologic malignancies were exon 11 and analyze the mutations.Result Analysis of 304 cases of different blood tumor patients (138 cases of AML, 39 cases of ALL,43 cases of CML,16 cases of CLL,15 cases of MDS,22 cases of MM,31 cases of NHL) and 10 cases of non malignant tumor patients in FLT3-ITD gene mutation distribution characteristics in hematologic disease results as follows:1. The age of AML and ALL group was significantly higher than that in AML and ALL group, and the difference was statistically significant.2.41 cases of AML were detected in 6 patients with FLT3-ITD mutation, the mutation rate was 14.63%, the mutation rate of NK-AML was 14.29%, the mutation rate of AK-AML was 13.33%, the difference between the two groups was not statistically significant; Mutations in 38 patients with refractory AML were detected in 6 patients, the mutation rate was 15.79%, all occurred in patients with abnormal karyotype, but the difference was not statistically significant;In AML-CR patients were not detected mutations; the first diagnosis of AML and the recurrence of refractory AML patients were significantly higher than the mutation rate of AML-CR patients, the difference was statistically significant;In the study,1 cases were detected positive for FLT3-ITD mutation at the first diagnosis, and the mutation was still detected after 3 courses of chemotherapy.Mutation of newly diagnosed AML patients and wild type patients in age, gender, WBC, HGB, PLT count, FAB points difference and course of 2 CR rate was not significant, but compared to the percentage of bone marrow blast cells, mutant group was significantly higher than that of the wild type group, the difference is statistically significant, and relapsed or refractory AML mutation patients and wild type patients in clinical features compared, the difference was not statistically significant.3. In 41 patients with newly diagnosed AML patients detected in 1 case of FLT3-ITD combined with NPM1 mutation, Dnmt3a gene mutations, FAB classification for the M5;1 cases of FLT3-ITD mutation combined with NPM1 gene mutation, FAB classification for the M4, Yu was not found with other gene mutation combined.4.15 cases of MDS were detected in 1 cases of FLT3-ITD mutation (1/15), MDS-RAEB-2, mutation in patients with WBC counts were significantly higher than that of wild group, the difference was statistically significant, no significant difference in clinical characteristics of more than. With the mutation of MDS patients after January to AML-M4.5.31 cases of NHL were detected in 1 patients with FLT3-ITD mutations, according to the 2008 WHO (WHO) classification criteria belonging to T lymphoblastic leukemia/lymphoma, which has not been reported in the international.6. FLT3-ITD mutations were not found in ALL, CML, CLL, MM, and non hematologic tumors.Conclusions1.FLT3-ITD mutations mainly occurred in patients with AML, and with high percentage of bone marrow blast cells and high and low remission rate and poor prognosis of AML important molecular markers.2.FLT3-ITD mutations in patients with relapsed refractory AML have a high frequency of mutations, suggesting that the mutation is a marker of refractory AML recurrence.3.NPM1, FLT3-ITD and DNMT3a genes may be more likely to occur in the nucleus pulposus.4. FLT3-ITD mutation may be related to the progression of MDS disease, which may be the risk factor of MDS to AML transformation.5. FLT3-ITD mutations may occur in T lymphoblastic leukemia/lymphoma, which may be related to its prognosis. We detected the cases in the world reported, further in-depth study samples.