Ying Y.,Guangzhou First Municipal Peoples Hospital |
Chen J.-L.,Guangzhou First Municipal Peoples Hospital |
Chen J.-L.,Guangdong Key Laboratory of Clinical Molecular Medicine and Diagnostics |
Wang H.-P.,Guangzhou First Municipal Peoples Hospital |
And 4 more authors.
Chinese Journal of Cancer Prevention and Treatment | Year: 2013
OBJECTIVE: To evaluate the prevalence of nucleophosmin1 (NPM1) and FMS-like tyrosine kinase-3 (FLT3) gene internal tandem duplication (FLT3-ITD) mutations in patients with primary acute myeloid leukemia (AML) and to assess their clinical and prognostic significance. METHODS: Using high-resolution melting curve (HRM) and denaturing high performance liquid chromatography (DHPLC) technology NPM1 and FLT3-ITD mutations were detected in 103 patients with primary AML respectively. REULTS: NPM1 and FLT3-ITD mutations were found in 31 cases (30.1%) and 20 cases (19.4%) respectively in 103 patients with primary AML. Moreover, higher mutation percentage was found in AML patients with normal karyotype (47.6% and 26.2%, respectively). FLT3-ITD mutation was significantly associated with higher peripheral white cell (t=2.21, P=0.037) and bone marrow blast cells counts (t=2.44, P=0.023). NPM1 mutation was also significantly associated with higher peripheral white cell count (t=2.24, P=0.034). In primary AML patients excluding APL, there was no difference in CR rate between NPM1 mutation and wild group, but higher CR rate of first induction chemical therapy was achieved in NPM1 mutation group (76.9% vs 35.0%, χ2=12.78, P=0.00035). Compared with wild group, the total CR rate and the CR rate after first induction chemical therapy was significantly lower in FLT3-ITD mutation group (58.8% vs 82.6%, χ2=4.48, P=0.034; 17.6% vs 55.1%, χ2=6. 23, P=0. 012). According to CR rate and RR within the first year, the NPM1+/FLT3-ITD-group showed a better prognosis (CR 85.0%, RR 17.6%), compared with the other groups. Adversely, the NPM1-/FLT3-ITD+ group was the poorest in prognosis (CR 54.5%, RR 50.0%). CONCLUSIONS: NPM1 and FLT3-ITD mutations are common in patients with primary AML and associated with prognosis. The detection of NPM1 and FLT3-ITD mutations will be beneficial for individual therapy and prognostic assessment in patients with AML.