Clinical Characteristics and Prognostic Relevance of Co-Mutated Genes in Acute Myeloid Leukemia Patients with FLT3 Mutations
10.19746/j.cnki.issn1009-2137.2024.04.009
- VernacularTitle:伴FLT3突变的急性髓系白血病患者共突变基因的临床特征及与预后的关系
- Author:
Yang CHEN
1
,
2
;
Yan-Yan XIE
;
Yu FANG
;
Ming HONG
;
Wen-Jie LIU
;
Xuan ZHOU
;
Wei ZHANG
;
Jin-Ning SHI
;
Si-Xuan QIAN
Author Information
1. 南京医科大学附属江宁医院血液内科,江苏南京 211100
2. 南京医科大学第一附属医院血液内科,江苏南京 210029
- Keywords:
acute myeloid leukemia;
FLT3;
co-mutated gene;
TET2;
prognosis
- From:
Journal of Experimental Hematology
2024;32(4):1032-1038
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics and influence of co-mutated gene on acute myeloid leukemia patients(AML)with FMS-like tyrosine kinase-3(FLT3)mutations.Methods:A total of 273 FLT3+AML patients were enrolled,and the co-mutation gene data of the patients were collected to further analyze the prognosis of the patients.FLT3 and other common mutations were quantified by PCR amplification products direct sequencing and second-generation sequencing(NGS).Results:When patients were divided into FLT3 ITD+,FLT3 TKD+,FLT3 ITD++TKD+and FLT3 ITD-+TKD-group according to the type of FLT3 mutations,it was found that the frequencies of TET2,GATA2,NRAS and ASXL1 mutation were significantly different among the 4 groups(all P＜0.05).When patients were divided into allelic ratio(AR)≥0.5 and＜0.5 group,it was found that the frequencies of FLT3 ITD+,FLT3 ITD-+TKD-,NPM1,NRAS and C-kit were significantly different between the two groups(all P＜0.05).When patients were divided into normal and abnormal karyotype group,it was found that the frequencies of FLT3 ITD+,FLT3 TKD+,NPM1,GATA2 and C-kit were significantly different between the two groups(all P＜0.05).The median overall survival(OS)of AML patients with FLT3 TKD+(including FLT3 ITD++TKD+)was longer than that of patients with FLT3 ITD+alone(P＜0.05).The OS and relapse-free survival(RFS)of AML patients with FLT3++TET2+were both shorter than those of patients with FLT3++TET2-(both P＜0.05).Conclusion:The mutation frequencies of co-mutated genes are correlated with subtypes of FLT3,karyotype and AR.AML patients with FLT3 TKD+have longer OS than patients with FLT3 ITD+alone,and patients with co-mutation of TET2 have shorter median OS and RFS.
