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12th Congress of the European Hematology ... - Haematologica

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0056<br />

PROGNOSTIC SIGNIFICANCE OF FLT3/ITD MUTATION IN PATIENTS WITH AML1/ETO<br />

ASSOCIATED ACUTE MYELOID LEUKEMIA<br />

Y.-K. Kim, 1 H.N. Kim, 2 I.K. Lee, 2 D.Y. Jo, 3 J.H. Won, 4 J.H. Choi, 2<br />

S.R. Lee, 1 H.J. Shim, 1 J. S. Ahn, 1 D.H. Yang, 1 J.J. Lee, 1 H.S. Park, 4<br />

H.J. Kim 1<br />

1 Chonnam National University Hwasun Hosp, JEOLLANAM-DO; 2 GRCHD,<br />

Chonnam Natl. Univ. Hwasun Hosp., JEOLLANAM-DO; 3 Chungnam<br />

National University Hospital, DAEJEON; 4 Soonchunhyang Univ. College <strong>of</strong><br />

Med., SEOUL, South-Korea<br />

Background. AML1/ETO fusion gene in acute myeloid leukemia (AML)<br />

usually predicts a good response to chemo<strong>the</strong>rapy with a high remission<br />

rate and a relatively long median survival. An internal tandem duplication<br />

<strong>of</strong> <strong>the</strong> FLT3 gene (FLT3/ITDs) is known to be associated with poor<br />

outcome in AML patients. In <strong>the</strong>se days, animal study showed that <strong>the</strong><br />

dual presentation <strong>of</strong> AML1/ETO fusion gene and <strong>the</strong> FLT3 length mutation<br />

collaborate in inducing acute leukemia in mice. Aims. To determine<br />

<strong>the</strong> prognostic role <strong>of</strong> FLT3/ITD mutation in patients with AML1/ETO<br />

positive AML. Methods. FLT3/ITD mutation status was evaluated by performing<br />

DNA polymerase chain reaction assays on 38 bone marrow<br />

samples obtained at initial diagnosis from <strong>the</strong> patients with AML1/ETO<br />

fusion gene positive AML. GeneScan analysis was performed to confirm<br />

<strong>the</strong> FLT3/ITD mutation and to measure mutant levels. Results. Of total<br />

38 patients, 9 patients (23.7%) demonstrated <strong>the</strong> aberrant FLT3/ITD<br />

mutations. The median age <strong>of</strong> patients was 37 years (range, 18-75 years).<br />

There were 23 males (60.5%) and 15 females (39.5%). There was no statistically<br />

significant difference in age, gender, leukocyte count, hemoglobin<br />

level, platelet count and percentage <strong>of</strong> peripheral or bone marrow<br />

blasts between <strong>the</strong> patients with FLT3/ITD and <strong>the</strong> patients without<br />

FLT3/ITD. To analyze <strong>the</strong> response to or outcome <strong>of</strong> <strong>the</strong>rapy, we evaluated<br />

33 patients who received intensive induction chemo<strong>the</strong>rapy containing<br />

cytarabine. In univariate analysis, <strong>the</strong>re was no significant difference<br />

in complete response rate (100% vs. 95.8%, p=0.53). However, <strong>the</strong><br />

presence <strong>of</strong> FLT3/ITD was associated with higher relapse rate in <strong>the</strong>se<br />

patients (77.8% vs. 30.4%, p

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