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document
The FLT3ITD mRNA level has a high prognostic impact in NPM1 mutated , but not in NPM1 unmutated , AML with a normal karyotype . The impact of a FLT3-internal tandem duplication ( FLT3ITD ) on prognosis of patients with acute myeloid leukemia ( AML ) is dependent on the ratio of mutated to wild-type allele . In 648 normal karyotype ( NK ) AML patients , we found a significant independent effect of the quantitative FLT3ITD mRNA level -- measured as ( FLT3ITD/wtFLT3 ) / ( FLT3ITD/wtFLT3+1 ) -- on outcome . Moreover , this effect was clearly seen in 329 patients with a mutated NPM1 gene ( NPM1+ ) , but not in 319 patients without a NPM1 mutation ( wtNPM1 ) . In a multivariate Cox regression model , the quantitative FLT3ITD mRNA level showed an independent prognostic impact on overall survival ( OS ) and relapse-free survival ( RFS ) only in the NPM1+ subgroup ( OS : hazard ratio , 5.9 ; [ 95 % confidence interval [ CI ] : 3.1-11.2 ] ; RFS : hazard ratio , 7.5 [ 95 % CI : 3.4-16.5 ] ) . The FLT3ITD mRNA level contributes to relapse risk stratification and might help to guide postremission therapy in NPM1-mutated AML .
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Intervention_Physical
FLT3ITD mRNA
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Intervention_Pharmacological
level
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Intervention_Physical
FLT3ITD
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Intervention_Physical
FLT3ITD
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Intervention_Physical
FLT3ITD
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Outcome_Physical
quantitative FLT3ITD mRNA level -- measured
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Outcome_Mortality
overall survival
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Outcome_Mortality
relapse-free survival
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Participant_Condition
NPM1 mutated
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Participant_Condition
but not in NPM1 unmutated
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Participant_Condition
AML with a normal karyotype
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Participant_Condition
patients with acute myeloid leukemia ( AML )
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Participant_Sample-size
648
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Participant_Sample-size
329
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Participant_Sample-size
319
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Participant_Condition
NPM1-mutated AML