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FLT3 internal tandem duplication in patients with acute promyelocytic leukemia

ZHU Yong-mei LIU Yuan-fang ZHANG Su-jiang SHEN Zhi-xiang HU Jiong Department of Hematology,Shanghai Institute of Hematology,RuiJin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200025,China  
Objective To analyze the mutation of FLT3 internal tandem duplication(FLT3-ITD)in bone marrow cells from patients with newly-diagnosed acute promyelocytic leukemia(APL).Methods The mutation of FLT3-ITD in bone marrow mononuclear ceils(MNCs)from 103 APL patients were screened by polymerase chain reaction(PCR)and the clinical features of ITD positive patients were analyzed.Results FLT3-ITD mutations were identified in 19.4%(20/103)patients.It was associated with short/variant form of PML-RARαisoforms(P0.0001).Among the 20 patients with FLT3-ITD mutation,16 presented with short,2 with variant and 2 with long form of PML-RARαisoforms.Patients with FLT3-ITD mutation also presented significantly higher initial peripheral white blood cell count(WBC)(P0.01),especially in those with short/variant PML-RARα isoforms(P=0.015).For patients with long form PML-RARα,there was no significant difference in initial WBC.Out of FLT3-ITD positive patients,18/20(90%)obtained complete remission and 16 evaluable patients(2 lost follow-up)remained in first remission in a median fol- low-up of 26(11-47)months.Conclusion FLT3-ITDs are frequently identified in patients with newly di- agnosed APL.FLT3-ITD mutation is associated with short/variant form of PML-RARα fusion gene and higher initial WBC.No significant impact on treatment outcome was observed with a limited follow-up.
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