【摘要】 目的:分析酪氨酸激酶受体基因FLT3突变在急性髓系白血病(AML)复发前后的变化及其对预后的影响。方法:22例在初诊及复发后均行FLT3-ITD/TKD检测的AML患者中,初诊时FLT3-ITD/TKD突变阳性者(FLT3+组)与阴性者(FLT3-组)各11例。分析2组患者临床基本特征、复发后FLT3突变转阳率、二次缓解率、无病生存(DFS)及总生存(OS)。结果:FLT3+组复发后,FLT3突变转阳率为90.9%(10/11),二次缓解率为9.1%(1/11);FLT3-组复发后,FLT3突变转阳率为27.3%(3/11),二次缓解率为27.3%(3/11)。2组间二次缓解率比较差异无统计学意义(P=0.586)。FLT3+组中位DFS为5(2~22)个月,FLT3-组中位DFS为5(3~19)个月,差异无统计学意义(P=0.531)。FLT3+组中位OS为12(7~33)个月,FLT3-组中位OS为15(6~40)个月,差异无统计学意义(P=0.208)。结论:AML伴有初诊FLT3+患者预后较差,该突变具有不稳定性,因而作为微小残留病的监测指标需慎重。更多还原

【Abstract】 Objective:To investigate the change of FLT3mutations in acute myeloid leukemia(AML)in newly diagnosed and relapsed patients and the prognostic impact.Method:Twenty-two AML patients who received FLT3mutations tests at first diagnosis and after relapse were recruited.At first diagnosis,11patients were positive(FLT3+group)and 11cases were negative(FLT3-group)in mutations tests.The basic clinical characters,the incidence of FLT3mutations after relapse,secondary complete remission(CR2)rate,disease free survival(DFS),overall survival(OS)of two groups were analyzed.Result:The mutation rate after relapse in FLT3+group was90.9%(10/11)and in the FLT3-group was 27.3%(3/11).The CR2rates of FLT3+group and FLT3-group were 9.1%(1/11)and 27.3%(3/11),respectively(P=0.586).The median DFS were 5(2to 22)months and 5(3to 19)months in FLT3+group and FLT3-group,respectively(P=0.531).The median OS were 12(7to 33)months and 15(6to 40)months in FLT3+group and FLT3-group,respectively(P=0.208).Conclusion:The AML patients with FLT3 mutations show an unfavorable prognosis.The FLT3 mutations are unstable and it should be cautious to use it as a marker of MRD monitoring.更多还原