FLT3-ITD突变阳性急性髓系白血病的临床特征和预后因素

OBJECTIVE: To investigate the clinical significance and prognosis factors of acute myeloid leukemia (AML) with FLT3 mutation-internal tandem duplication (FLT3-ITD) and provide more evidence for prognosis evaluation in AML with FLT3-ITD. METHODS: The clinical characteristics and outcomes of 98 AML with FLT3-ITD were analyzed. RESULTS: In patients with FLT3-ITD positive AML, the median of WBC and peripheral blood blast at initial diagnosis were 58.2 (0.3–461.8) ×10(9)/L and 42.2 (0–397.1) ×10(9)/L, respectively. The complete remission (CR) rate after one course induction therapy was 60.6% in 71 patients with intermediate or adverse risk. The primary refractory rate was 26.8% in 71 patients with intermediate or adverse risk. The lower number of peripheral blood blast was a favorable factor to achieve CR after one course induction therapy (P=0.009). CR after one course (HR=0.395, 95% CI 0.183–0.85, P=0.001) and allo-transplantation in CR(1) (HR=0.180, 95% CI 0.043–0.752, P=0.018) favored longer relapse-free survival (RFS). CR after one course (HR=0.251, 95% CI 0.121–0.523, P< 0.001) and lower number of peripheral blood blast (HR=0.219, 95% CI 0.088–0.545, P=0.003) favored longer overall survival (OS) in AML with FLT3-ITD. CONCLUSION: FLT3-ITD positive AML with lower number of peripheral blood blast has a relative favorable prognosis. CR after one course and allotransplantation in CR(1) are important strategy to improve prognosis in AML with FLT3-ITD.