To Investigate FLT3and NPM1Mutation In Patients With Acute Myeloid Leukemia And Analysis Of Its Clinical Significance

ObjectiveTo investigate FLT3and NPM1mutation in patients who were highly suspected acute myeloid leukemia in clinical with acute leukemia and analysis of its clinical significance, which could elevate the prognosis in AML patients.MethodA study is on44patients with AML who were treatment in the First Affiliated Hospital, College of Medicine, Zhejiang University during November in2010to October in2011. Polymerase chain reaction (PCR) was applied to identify FLT3and NPM1mutation, then we analyzed the incidence of the FLT3and NPM1mutation and explored the correlation between the FLT3and NPM1point mutation and the prognosis in patients with FLT3and NPM1point mutation who were highly suspect AML in clinical.ResultsIn all the44patients, the FLT3gene mutation detection rate was22.7%(10/44), the NPM1mutation detection rate was31.8%(14/44), where FLT3mutations associated with NPM1mutation was9.1%(4/44). In the FAB, the FLT3mutations group, it can be detected in M1, M2, M3, M5, M6, the highest is M6; In the NPML mutations group, it can be detected in M0, M1, M2, M4, M5, MO was the highest. In the normal chromosome group, the positive rate of FLT3was22%(8/36), the positive rate of NPM1was33.3%(12/36).In the chromosome aberrant group, the positive rate of FLT3was33.3%(2/6), the positive rate of NPM1was33.3%(2/6); the incidence of FLT3+/NPM1+is0%(0/8), the incidence of FLT3+/NPM1-is25%(2/8), the incidence of FLT3-/NPM1-is50%(4/8), the incidence of FLT3-/NPM1+is25%(2/8).In the first induction chemotherapy treatment without remission, the FLT3mutant group was60%(6/10), the NPM1mutant group was42.9%(6/14).FLT3mutation accompanied by mutations in NPML group was50%(2/4). In the recurrence of the disease group, the FLT3gene mutation was10%(1/10), NPM1gene mutations was10%(1/10), FLT3mutation accompanied by mutations in NPML group was0%(0/4). In the higher white blood cell which is higher than100*109/L group, FLT3gene mutation was44.4%(4/9), NPM1mutation was66.7%(6/9).Conclusion1. In adult acute myeloid leukemia, FLT3and NPM1is the most common cytogenetic abnormalities.2. According to the FAB classification, mutations in FLT3group, the FLT3mutations group, it can be detected in M1, M2, M3, M5, M6, the highest is M6; in the NPML mutations group, it can be detected in M0, M1, M2, M4, M5, M0was the highest.In the newly diagnosed patients whose white blood cells higher than100*109/L group, the incidence of negative FLT3gene; NPM1gene mutation in patients with positive rate is greater than the negative. The high white blood cell is considered high-risk groups, also have certain significance in evaluating the prognosis of the disease.3. In the first induction chemotherapy treatment without remission, FLT3group is the worst,FLT3+/NPM1+group have a better prognosis than the FLT3,NPM1is better than FLT3+/NPM1+group.4. In the relapse group, we can also get to know that FLT3+/NPM1+have a better prognosis than the other.