Prognosis and outcome of patients with acute myeloid leukemia based on FLT3‑ITD mutation with or without additional abnormal cytogenetics

Abstract

The FMS-like tyrosine kinase 3-internal tandem duplication (<i>FLT3-ITD</i>) gene mutation is present in ~20% of patients with <i>de novo</i> acute myeloid leukemia (AML). Patients with an <i>FLT3-ITD</i> mutation have a poor prognosis. However, the prognostic function of <i>FLT3-ITD</i> combined with other cytogenetic abnormalities are not clear. In the present study, a retrospective analysis of 103 newly diagnosed patients with AML was performed. The results revealed that the overall survival (OS) and recurrence-free survival (RFS) times were significantly longer in patients with an <i>FLT3-ITD</i> mutation combined with other favorable risk genes, compared with in those patients with a single <i>FLT3-ITD</i> mutation (P=0.0361 and P=0.0426). Sorafenib combined with chemotherapy significantly improved the overall response rate (ORR) when compared with mono-chemotherapy (P=0.039), but no significant differences were observed in the OS and RFS. In conclusion, favorable-risk cytogenetics may improve the clinical outcomes of patients with <i>FLT3-ITD</i>-mutated AML, but adverse-risk cytogenetics may not further worsen the prognosis. Sorafenib combined with chemotherapy may increase the ORR but would not result in a longer OS and RFS.