The prognostic impact of FLT3-ITD and NPM1 mutation in adult AML is age-dependent in the population-based setting
The prognostic impact of FLT3-ITD and NPM1 mutation in adult AML is age-dependent in the population-based setting
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DOI：
10.1182/bloodadvances.2019001335
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发表时间：
2020-03-24
期刊：
影响因子：
7.5
通讯作者：
Hoglund, Martin
中科院分区：
文献类型：
--
作者：
Juliusson, Gunnar;Jadersten, Martin;Hoglund, Martin
在急性髓系白血病(AML)中，Flt3内串联重复(ITD)和核磷蛋白1(NPM1)突变通过治疗的选择提供了与临床相关的预后信息，但年龄和性别对这些分子标志物的影响尚未得到评估。瑞典急性髓细胞白血病注册中心包含了可追溯到2007年的有关Flt3-ITD和NPM1突变的数据，报告了1570名年龄在75岁以下的成人患者的分子结果。女性更常见的是Flt3(ITD)和/或NPM1(MUT)(Flt3(ITD)：女性，29%；男性，22%[P-.00151；NPM1(MUT)：女性，36%；男性，27%[P<；.0001])，更多的男性双阴性(女性，53%；男性，；P<；.0001)。与NPM1(MUT)患者(62岁比60岁；P=.059)相比，患有FLT3(ITD)的患者年轻(59岁比62岁；P=.023)。有趣的是，它们的预后效果与年龄有很强的相关性：Flt3(ITD)表明年轻患者的存活率较低(
In acute myeloid leukemia (AML) FLT3 internal tandem duplication (ITD) and nucleophosmin 1 (NPM1) mutations provide prognostic information with clinical relevance through choice of treatment, but the effect of age and sex on these molecular markers has not been evaluated. The Swedish AML Registry contains data on FLT3-ITD and NPM1 mutations dating to 2007, and 1570 adult patients younger than 75 years, excluding acute promyelocytic leukemia, had molecular results reported. Females more often had FLT3(ITD) and/or NPM1(mut) (FLT3(ITD) : female, 29%; male, 22% [P - .00151; NPM1(mut) : female, 36%; male, 27% [P < .0001]), and more males were double negative (female, 53%; male, 64%; P < .0001). Patients with FLT3(ITD) were younger than those without (59 vs 62 years; P = .023), in contrast to patients with NPM1(mut) (62 vs 60 years; P = .059). Interestingly, their prognostic effect had a strong dependence on age: FLT3(ITD) indicated poor survival in younger patients (