FLT3 Internal Tandem Duplication Mutation As A Prognostic Marker In AML Patients With Normal Karyotype

Introduction and aim of the work: Numerous genetic abnormalities inacute myeloid leukemia (AML) have been identified. The FMS-liketyrosine kinase 3 (FLT3) is one of the key molecules with a role in thepathogenesis in AML. It plays an important role in stem cell proliferation,differentiation, and survival. The most common mutation in the FL T3gene is internal tandem duplication (FLT3/ITD). This work aimed tostudy the prognostic value of FLT3-ITD mutation in acute myeloidleukemia patients with normal karyotype. Patients, material andmethods:This study comprised two groups; the patient group included 35acute myeloid leukemia (AML) patients (12 males and 23 females, theirages ranged from 20-62 years) and the control group included 15 healthycontrols (6 males and 9 females, their ages ranged from 22-55 years. Allstudied persons were subjected to the following; clinical evaluationincluding full history taking and thorough clinical examination and~ inv~stigationL including radiologica studiesand-e. Iaboratery-« ---- -investigations.The laboratory investigations were routine: staining ofbone marrow films with Leishman and myeloperoxidase cytochemistryand immunophenotyping by flowcytometry. Special investigationsincluded cytogenetic analysis using G banding technique for patients anddetection of FLT3-ITD mutation by genomic peR technique in patientswith normal karyotype and healthy controls.Results:As regards presenceof FLT3-ITD in both groups, there was a statistically significantdifference between them where 33.3% (7/21) of AML patients werepositive while it was not detected in any of healthy controls.Afterinduction therapy, 66.7% (14/21) of patients with normal karyotypeachieved Ck, while NR was encountered in 33.3% (7/21) of patients. Ckafter initial chemotherapy was lower in FLT3-ITD+ patients; 3/7 (42.9%)than that in FLT3-ITD- ones; 85.7% (12114) with statistically significantdifference.Conclusion:Presence of FLT3-ITD is prognostic factor forworse haematological characterization of acute myeloid leukemia patientswith normal karyotype.