摘要：

Background: Acute myeloid leukemia (AML) is a heterogeneous disorder characterized by clonal expansion of myeloid progenitors in the bone marrow and peripheral blood Objectives: This study aimed to assess the role of FMS-like tyrosine kinase 3-Internal Tandem Duplication (FLT3 -ITD) gene mutation in AML patients and to find out the impact of the CD34 expression in these cases. Subjects & Method: 30 adult newly diagnosed AML patients were included in this study. They were 20 males and 10 females, their ages ranged from 18-60 years with median age of 45.6 years for molecular detection of FLT3-ITD gene mutation by PCR technique. Results: FAB subtypes of the cases revealed that the most prevalent FAB subtype was M5, M2, M4 presented by (50%, 30%, 20%), respectively. Patients were classified into favorable (6.6%), intermediate (80%) and unfavorable (13.3%) according to cytogenetic abnormalities. Mean value of CD34% (± SD) among cases was 45.53±25.32 with range (5-91), while it was 42.52±29.9 with range (5-91) among FLT3-ITD positive cases and 44.21±22.67 with range (16-88) among FLT3-ITD negative cases with no significant statistical relation between FLT3-ITD gene and CD34, P (0.672). CD34 positivity among FLT3-ITD positive cases showed 9 cases (75%) CD34% positive and 3 cases (25%) CD34% negative while among FLT3-ITD negative cases there were 15 cases (83.3%) CD34% positive and 3 cases (16.7%) CD34% negative, with no significant statistical relation. As regard the outcome, among FLT3-ITD positive cases 5 cases (41.7%) were relapsed and 7 cases (58.3%) died. On the other hand among FLT3-ITD negative cases one case (5.6%) was relapsed and 11 cases (61.1%) died, There is significant elevation in the relapsed cases among the FLT3-ITD positive cases in relation to the negative group with (P = 0.025), while there is no significant relation between FLT3-ITD gene and death with (P = 0.879). Kaplen Meier survival analysis in respect to FLT3-ITD shows that patients with FLT3-ITD gene negative had better median overall survival with (p <0.05) FLT3-ITD positivity contributes to a short CR duration and lower CR rate. Conclusion: The bad prognosis of FLT3-ITD mutation is the most effective factor in determination of the line of treatment due to high incidence of relapse in FLT3-ITD positive cases.

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