FLT3基因突变在急性早幼粒细胞白血病中的临床意义

Clinical significance of FLT3 gene mutations in patients with acute promyelocytic leukemia

目的分析FLT3基因突变在急性早幼粒细胞白血病(APL)中的临床意义。方法抽取34例APL患者骨髓标本,采用PCR、RT-PCR和DNA酶切技术检测FLT3基因内部串连重复(FLT3-ITD)、FLT3基因D835突变(FLT3-D835),并分析它们与患者临床表现、症状、疗效的关系。结果APL患者外周血高WBC数(WBC≥10×109/L)的阳性率,FLT3-ITD突变型明显高于FLT3-ITD野生型(P<0.05),而FLT3-D835突变与其野生型差异无显著性;骨髓原始细胞+早幼粒细胞之和高含量(≥80%)、B级出血症状、完全缓解(CR)阳性率,FLT3突变型与FLT3野生型患者差异均无统计学意义(P>0.05)。结论大部分FLT3-ITD突变型APL患者常表现高外周血WBC数,骨髓原始细胞与早幼粒细胞之和高含量,B级出血症状及CR率与野生型患者无显著差异。

Objective To explore the clinical significance of FLT3 gene mutations in patients with acute promyelocytic leukemia（APL）.Methods Bone marrows from 34 patients with APL were aspirated.Gene mutations of internal tandem duplication（FLT3-ITD）and D835 mutations（FLT3-D835）were detected by PCR,RT-PCR and enzyme digestion,respectively.The relationship between FLT3 gene mutations and the clinical manifestation,symptom and therapeutic efficacy of the patients were analyzed.Results The positive rate of patients who had high initial peripheral white blood cell（WBC）count（WBC≥10×109/L）was higher in the FLT3-ITD mutant patients than that of FLT3-ITD wild patients（P0.01）,which was not between FLT3-D835 mutant and FLT3-D835 wild patients.The positive rate of the patients who had high percentage of myeloblasts plus premyelocyte cells in bone marrow（≥80%）,hemorrhage symptom B-grade and complete remission（CR）rate had no statistical differences between FLT3 mutant and FLT3 wild patients.Conclusion Most FLT3-ITD mutant APL patients usually present high initial peripheral WBC count,but there is no significant difference in the percentage of high count of bone marrow myeloblasts plus premyelocyte cells,hemorrhage symptom and CR rate between FLT3 mutant and FLT3 wild APL patients.