FLT3-ITD突变与附加染色体核型对急性早幼粒细胞白血病患者预后的影响

Effect of FLT3-ITD mutations and additional chromosomal karyotypes on the prognosis in patients with acute promyelocytic leukemia

目的探讨FLT3-ITD突变与附加染色体核型对急性早幼粒细胞白血病(APL)患者预后的影响。方法回顾性分析2012年1月~2021年3月安徽医科大学第二附属医院新诊断为APL的患者112例,收集患者临床和实验室资料,根据危险度分层选择治疗方案,通过电话或查看门诊或住院病历来完成随访总生存(OS)。结果APL患者合并FLT3-ITD基因突变28例(25.0%),有附加染色体核型患者19例(16.9%),早期死亡(ED)9例(8.0%)。有无FLT3-ITD突变患者完全缓解率(CR)差异无统计学意义(P>0.05);ED及高危分层无明显相关性(P>0.05)。有无附加染色体核型患者CR率差异无统计学意义(P>0.05),与ED及高危分层无明显相关性(P>0.05)。中位随访68.5(0.1~108.0)月,总体生存率80.4%,有无高危FLT3-ITD突变的生存率差异无统计学意义(P>0.05)。有无附加染色体核型患者的生存率分别为78.9%、80.6%(P>0.05)。结论FLT3-ITD突变与附加染色体核型对APL患者长期生存没有影响。

Objective To investigate the effect of the FLT3-ITD mutation and the additional chromosomal karyotype on the prognosis of patients with acute promyelocytic leukemia(APL).Methods A total of 112 patients newly diagnosed with APL in The Second Affiliated Hospital of Anhui Medical University from January 2012 to March 2021 were retrospectively analyzed.Clinical and laboratory data were collected.Treatment was selected according to risk stratification.Results 28 APL patients with FLT3-ITD gene mutations,19 patients with additional chromosome karyotype and 9 early deaths(ED).Complete remission rate(CR)in patients with or without FLT3-ITD mutation was 85.7%and 91.6%(P>0.05).There was no obvious correlation with ED and high-risk stratification(P>0.05).The CR rate of patients with or without additional chromosomal karyotype was 78.9%vs 90.3%(P>0.05),and no obvious correlation with ED and high-risk stratification(P>0.05).Median follow-up of 68.5(0.1-108.0)month,overall survival was 80.4%,with and without FLT3-ITD mutations was 78.6%and 81.0%,respectively(P>0.05).Survival rate in patients with or without additional chromosomal karyotypes was 78.9%and 80.6%,respectively(P>0.05).Conclusion FLT3-ITD mutation and additional chromosomal karyotype had no effect on long-term survival of APL patients.