Heterogeneity of FLT3 mutations and prognostic implications in acute myeloid leukemia
10.12354/j.issn.1000-8179.2024.20241370
- VernacularTitle:FLT3突变多样性及对急性髓系白血病预后的影响
- Author:
Guo JIANGANG
1
;
Wu TINGKAI
;
Yu XIAODA
;
Wang ANAN
;
Li JIAJING
;
Liu BEI
Author Information
1. 兰州大学第一临床医学院(兰州市 730000)
- Publication Type:Journal Article
- Keywords:
FLT3;
acute myeloid leukemia(AML);
co-mutation;
prognosis
- From:
Chinese Journal of Clinical Oncology
2024;51(23):1212-1217
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the heterogeneity of FLT3 mutations and the consequences of co-occurring mutations on the clinical features and prognosis of patients with acute myeloid leukemia(AML).Methods:We retrospectively analyzed the clinical characteristics of 80 patients with AML who carried FLT3 mutations,as detected by genetic testing,and were treated in The First Hospital of Lanzhou Uni-versity from October 2017 to March 2024.An analysis was performed to evaluate the impact of FLT3 mutation frequency,insertion length of base pairs,insertion site,and co-occurring mutations on survival outcomes.Results:The variant allele frequency(VAF)of FLT3-ITD muta-tions was correlated with leukocyte counts and lactate dehydrogenase levels in patients with de novo AML.There was an association between the insertion site and the length of the base-pair insertion.Patients with AML who also had a VAF of FLT3-ITD mutations greater than or equal to 0.38 exhibit reduced overall survival(OS),whereas the length of base pair insertion,insertion site,and number of muta-tions did not correlate with OS.Patients with non-classical FLT3 mutations demonstrated a significantly longer OS than did those with FLT3-ITD mutations.The co-occurrence of FLT3-ITD,NPM1,and DNMT3A mutations was associated with markedly reduced OS.The use of FLT3 inhibitors and allogeneic hematopoietic stem cell transplantation(allo-HSCT)can improve the prognosis of patients with FLT3-ITD mutations.Conclusions:FLT3 mutational heterogeneity correlates with the clinical characteristics and outcomes of patients with AML.Non-classical FLT3 and FLT3-TKD mutations are associated with superior prognosis.Patients with a VAF of 0.38 or higher have a poorer prognosis,but the use of FLT3 inhibitors can improve their prognosis.Patients with triple mutations have poor prognosis.
