International Journal of Hematology

DOI: 10.1007/s12185-017-2256-7 Pages: 552-561

FLT3-ITD with DNMT3A R882 double mutation is a poor prognostic factor in Chinese patients with acute myeloid leukemia after chemotherapy or allogeneic hematopoietic stem cell transplantation

1. The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Department of Hematology

2. Institute of Blood and Marrow Transplantation

3. Soochow University, Collaborative Innovation Center of Hematology

4. Yinzhou People Hospital, Department of Hematology

5. Soochow University, Department of Pharmacology, College of Pharmaceutical Sciences

Correspondence to:
Xiaowen Tang
Tel: +86-5126778156
Email: xwtang1020@163.com

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Abstract

To investigate clinical characteristics and outcomes of transplantation in AML patients with FLT3-ITD/DNMT3A double mutation, we retrospectively analyzed 206 Chinese patients with AML after Sanger sequencing. Our analysis showed that AML patients with FLT3-ITD and DNMT3A R882 mutations had a higher white blood cell count and a lower complete remission (CR) rate after first induction chemotherapy. All 206 patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT) in status of CR. These results indicate that AML patients with FLT3-ITD and DNMT3A R882 double mutation show a higher 2-year cumulative incidence of relapse (CIR), lower 2-year overall survival (OS) rate, and lower 2-year leukocyte-free survival (LFS) after allo-HSCT. The univariate and multivariate analyses confirmed that disease status prior to transplantation, FLT3-ITD, FLT3-ITD, and DNMT3A R882 double mutation were independent factors for poor prognosis after allo-HSCT. In summary, the present cohort study demonstrated that FLT3-ITD and DNMT3A R882 double mutation predicts poor prognosis in Chinese AML patients receiving chemotherapy or allo-HSCT treatment.

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