Potential Effects of the FLT3-ITD Mutation on Chemotherapy Response and Prognosis of Acute Promyelocytic Leukemia
Yu-hua Song,1 Peng Peng,1 Chun Qiao,2 Jian-yong Li,2 Qi-qiang Long,1 Hua Lu2 1Department of Haematology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China; 2Department of Haematology, First Affiliated Hospital of Nanjing Me...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2021-03-01
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| Series: | Cancer Management and Research |
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| Online Access: | https://www.dovepress.com/potential-effects-of-the-flt3-itd-mutation-on-chemotherapy-response-an-peer-reviewed-article-CMAR |
| _version_ | 1819181002323394560 |
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| author | Song Y Peng P Qiao C Li J Long Q Lu H |
| author_facet | Song Y Peng P Qiao C Li J Long Q Lu H |
| author_sort | Song Y |
| collection | DOAJ |
| description | Yu-hua Song,1 Peng Peng,1 Chun Qiao,2 Jian-yong Li,2 Qi-qiang Long,1 Hua Lu2 1Department of Haematology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China; 2Department of Haematology, First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, People’s Republic of ChinaCorrespondence: Hua LuDepartment of Haematology, First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, No. 300 Guangzhou Road, Gulou District, Nanjing, 210029, Jiangsu Province, People’s Republic of ChinaTel +86 13951717512Fax +86 025-83626373Email luhua1956@aliyun.comPurpose: To evaluate the influence of FLT3-ITD mutations on the treatment response and long-term survival of newly-diagnosed patients with acute promyelocytic leukemia (APL) treated with all-trans retinoic acid and arsenic trioxide.Methods: The long-term survival of 90 newly-diagnosed APL patients (age range 12– 75 years) was retrospectively analyzed.The FLT3-ITD mutation rate was assayed by polymerase chain reaction (PCR) amplification and sequencing analysis. Its impact on the treatment response, event-free survival(EFS), or overall survival(OS) was investigated in patients with and without the mutations.Results: The FLT3-ITD mutation rate in newly-diagnosed APL patients was 20% (18/90). The white blood cell (WBC) count at diagnosis in patients with mutations was significantly higher than that in patients without mutations while the FLT3-ITD mutation rate was higher in the high-risk group than in the low/intermediate-risk group. Patients with mutations had a significantly higher early death (ED) rate (16.67% vs 1.39%) for those lacking the mutation (P =0.024). However, the complete remission (CR) and differentiation syndrome (DS) rates in the two groups were similar. Kaplan Meier analysis for EFS and OS at five years showed a significant difference between the patients stratified by FLT3-ITD mutation status (log-rank P =0.010 and P =0.009, respectively).Conclusion: FLT3-ITD mutations can be related to high peripheral WBC counts in APL patients. APL patients with mutations displayed a higher ED rate compared to those without mutations. Patients carrying mutations had reduced five-year EFS and OS rates. Thus, reducing the overall death rate during induction treatment might be an effective way to improve the prognosis of patients with FLT3-ITD mutations.Keywords: acute promyelocytic leukemia, APL, FLT3-ITD, internal tandem duplication, ITD, prognosis, survival |
| first_indexed | 2024-12-22T22:23:18Z |
| format | Article |
| id | doaj.art-ddd8884e42ed4b0b82f75918ef830bd9 |
| institution | Directory Open Access Journal |
| issn | 1179-1322 |
| language | English |
| last_indexed | 2024-12-22T22:23:18Z |
| publishDate | 2021-03-01 |
| publisher | Dove Medical Press |
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| series | Cancer Management and Research |
| spelling | doaj.art-ddd8884e42ed4b0b82f75918ef830bd92022-12-21T18:10:38ZengDove Medical PressCancer Management and Research1179-13222021-03-01Volume 132371237863032Potential Effects of the FLT3-ITD Mutation on Chemotherapy Response and Prognosis of Acute Promyelocytic LeukemiaSong YPeng PQiao CLi JLong QLu HYu-hua Song,1 Peng Peng,1 Chun Qiao,2 Jian-yong Li,2 Qi-qiang Long,1 Hua Lu2 1Department of Haematology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China; 2Department of Haematology, First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, People’s Republic of ChinaCorrespondence: Hua LuDepartment of Haematology, First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, No. 300 Guangzhou Road, Gulou District, Nanjing, 210029, Jiangsu Province, People’s Republic of ChinaTel +86 13951717512Fax +86 025-83626373Email luhua1956@aliyun.comPurpose: To evaluate the influence of FLT3-ITD mutations on the treatment response and long-term survival of newly-diagnosed patients with acute promyelocytic leukemia (APL) treated with all-trans retinoic acid and arsenic trioxide.Methods: The long-term survival of 90 newly-diagnosed APL patients (age range 12– 75 years) was retrospectively analyzed.The FLT3-ITD mutation rate was assayed by polymerase chain reaction (PCR) amplification and sequencing analysis. Its impact on the treatment response, event-free survival(EFS), or overall survival(OS) was investigated in patients with and without the mutations.Results: The FLT3-ITD mutation rate in newly-diagnosed APL patients was 20% (18/90). The white blood cell (WBC) count at diagnosis in patients with mutations was significantly higher than that in patients without mutations while the FLT3-ITD mutation rate was higher in the high-risk group than in the low/intermediate-risk group. Patients with mutations had a significantly higher early death (ED) rate (16.67% vs 1.39%) for those lacking the mutation (P =0.024). However, the complete remission (CR) and differentiation syndrome (DS) rates in the two groups were similar. Kaplan Meier analysis for EFS and OS at five years showed a significant difference between the patients stratified by FLT3-ITD mutation status (log-rank P =0.010 and P =0.009, respectively).Conclusion: FLT3-ITD mutations can be related to high peripheral WBC counts in APL patients. APL patients with mutations displayed a higher ED rate compared to those without mutations. Patients carrying mutations had reduced five-year EFS and OS rates. Thus, reducing the overall death rate during induction treatment might be an effective way to improve the prognosis of patients with FLT3-ITD mutations.Keywords: acute promyelocytic leukemia, APL, FLT3-ITD, internal tandem duplication, ITD, prognosis, survivalhttps://www.dovepress.com/potential-effects-of-the-flt3-itd-mutation-on-chemotherapy-response-an-peer-reviewed-article-CMARacute promyelocytic leukemiaaplflt3-itdinternal tandem duplicationitdprognosissurvival. |
| spellingShingle | Song Y Peng P Qiao C Li J Long Q Lu H Potential Effects of the FLT3-ITD Mutation on Chemotherapy Response and Prognosis of Acute Promyelocytic Leukemia Cancer Management and Research acute promyelocytic leukemia apl flt3-itd internal tandem duplication itd prognosis survival. |
| title | Potential Effects of the FLT3-ITD Mutation on Chemotherapy Response and Prognosis of Acute Promyelocytic Leukemia |
| title_full | Potential Effects of the FLT3-ITD Mutation on Chemotherapy Response and Prognosis of Acute Promyelocytic Leukemia |
| title_fullStr | Potential Effects of the FLT3-ITD Mutation on Chemotherapy Response and Prognosis of Acute Promyelocytic Leukemia |
| title_full_unstemmed | Potential Effects of the FLT3-ITD Mutation on Chemotherapy Response and Prognosis of Acute Promyelocytic Leukemia |
| title_short | Potential Effects of the FLT3-ITD Mutation on Chemotherapy Response and Prognosis of Acute Promyelocytic Leukemia |
| title_sort | potential effects of the flt3 itd mutation on chemotherapy response and prognosis of acute promyelocytic leukemia |
| topic | acute promyelocytic leukemia apl flt3-itd internal tandem duplication itd prognosis survival. |
| url | https://www.dovepress.com/potential-effects-of-the-flt3-itd-mutation-on-chemotherapy-response-an-peer-reviewed-article-CMAR |
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