prevalencia de mutaciones FLT3 en Leucemia mieloide aguda en latinoamerica

jorge cuervo sierra preguntó sobre
Hematología y Hemoterapia

Arch Med Res. 2016 Jun 30. pii: S0188-4409(16)30051-0. doi: 10.1016/j.arcmed.2016.06.003. [Epub ahead of print]

Prevalence and Clinical Significance of FLT3 Mutation Status in Acute Myeloid Leukemia Patients in Two Latin American Countries: A Multicenter Study.

Cuervo-Sierra J1, Jaime Perez JC2, Martínez-Hernández RA1, García-Sepúlveda RD1, Sánchez-Cardenas M1, Gómez-Almaguer D1, Ortiz-Lopez R3, Villarreal-Villarreal CD1, Ruiz-Arguelles GJ4, Ruiz-Delgado G4, Lutz-Presno J4, Garcés-Eisele J4, Ignacio-Ibarra G5, Muciño-Hernández G6, Arana-Trejo RM6, Jiménez-Mejia AM7, Vásquez-Palacios G7.

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Abstract

BACKGROUND AND AIMS:

FLT3-ITD mutations in acute myeloid leukemia (AML) are associated with a poor prognosis. In Latin America, little epidemiological data exist about these mutations and their influence on clinical evolution and prognosis. Standardization and well-established clinical correlation make FLT3 mutational analysis by molecular methods an invaluable tool to decide among treatment options and to determine AML prognosis.

METHODS:

We assessed the prevalence of FLT3-ITD mutations in 138 patients with AML at four hematology referral centers from Mexico and Colombia. Molecular methods based on polymerase chain reaction (PCR) were employed for determining FLT3-ITD status.

RESULTS:

Mutations were present in 28 patients indicating a prevalence of 20.28%. Median age was 47 years (5-96). The FLT3 mutation positive group was older, had higher WBC and hemoglobin values and lower platelet counts but without statistical significance. A not previously described mutation in the FLT3 gene was found in one patient involving a nucleotide exchange of timine for cytosine at the 66608 position. A high mortality was found in the FLT3-mutated group, 67.8 vs. 42.72% in the non-mutated group and median survival was 4.9 months vs. 20.4 months, p = 0.009. A mutated FLT3 did not confer poor prognosis to those with M3 AML. The mutated FLT3 population had poor overall survival (OS) despite hematoprogenitor stem cell transplantation (HSCT).

CONCLUSION:

Prevalence of FLT3-ITD mutation in AML was present in a proportion comparable to other populations and, when present, was associated with a very poor prognosis.

Copyright © 2016 IMSS. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

AML; Acute myeloid leukemia; FLT3; Latin America

PMID: 27373815 DOI: 10.1016/j.arcmed.2016.06.003

[PubMed - as supplied by publisher]

18 de julio de 2016   Comentar