急性早幼粒细胞白血病FLT3-ITD突变分析

FLT3-ITD Mutation in Newly Diagnosed Patients with Acute Promyelocytic Leukemia

目的:研究FLT3-ITD突变对于急性早幼粒细胞白血病(APL)远期疗效的影响。方法:回顾性分析2002年1月至2010年12月本中心初诊170例APL患者的临床和预后特点。结果:170例初诊APL患者中,24例存在FLT3-ITD突变,阳性率14.1%,其中3例合并FLT3-TKD突变。FLT3-ITD+组患者发病时白细胞计数显著高于阴性组,高危组FLT3-ITD突变发生率最高。FLT3-ITD+组与阴性组的诱导死亡率分别为12.5%和2.9%(P=0.031),其诱导完全缓解(CR)率分别为83.3%和97.1%(P=0.004)。FLT3-ITD+组5年总生存率(OS)为87.5±6.8%,阴性组为90.6±2.6%(P=0.740),5年无病生存率(DFS)两组分别为82.8±9.1%和83.6±3.4%(P=0.928)。结论:FLT3-ITD突变与APL高白细胞数相关。伴FLT3-ITD突变APL诱导治疗死亡率高,CR率低,但FLT3-ITD突变对于APL长期DFS及OS无显著影响。

Objective：To evaluate the influence of FLT3-ITD mutation on long term survival of newly diagnosed patients with acute promyelocytic leukemia（APL）.Methods：Long term survival of 170 newly diagnosed APL patients was retrospective analyzed.Mutation rate of FLT3-ITD was assayed,and its influence on disease-free survival（DFS） or overall survival（OS） was analyzed.Results：The mutation rate of FLT3-ITD in newly diagnosed patients with APL was14.1%.WBC count at diagnosis was higer in FLT3-ITD positive group than that in negative group,and the mutation rate of FLT3-ITD was highest in high risk group.Induction death rate in FLT3-ITD positive and negative group were12.5%and 2.9%,respectively（P = 0.031）.Complete remission（CR） rate in 2 groups were 83.3%and 97.1%（P =0.004）.The 5- year OS rates in 2 groups were 87.5 ± 6.8%and 90.6 ± 2.6%（P = 0.740）.The 5- year DFS in 2groups were 82.8 ± 9.1%and 83.6 ± 3.4%（P = 0.928）.Conclusion：FLT3-ITD mutation is related with high peripheral white blood cell count in APL,the APL with FLT3-ITD mutation has higher induction death rate and lower CR rate than those in that without FLT3-ITD mutation,but FLT3-ITD mutation did not affect on long term DFS and OS.