Abstract
Background: FLT3-ITD mutation and NPM1 mutations dual detection has been proved to be significant in AML patients throughout the world.
Objectives: this study was designed to shed light on the significance of dual detection of FLT3-ITD mutation and NPM1 mutations in Iraqi AML patients for the first time.
Design and settings: this is a prospective study at a general community hospital in Baghdad (Baghdad Teaching Hospital) during the period from October 2010 till November 2011.
Patients and Methods: thirty two adult AML patients were enrolled within the study, in addition to 33 healthy adult chosen randomly as control group. FLT3-ITD mutation was detected using conventional PCR, whereas NPM1 mutations were detected using single strand confirmatory polymorphism-RT-PCR.
Results: about 47% of AML patients showed positive NPM1 mutations and 21.88 had FLT3-ITD mutation. 42.86% of patients with FLT3-ITD mutation had in addition NPM1 mutations. Patients who had both mutations constitute 20% of all NPM1 mutated cases (3/15), (P=.097).The largest number of patients were found in group one (FLT3-ITD_ve/NPM1_ve),
40.6%, and the least number were of group four (FLT3-ITD+ve/NPM1+ve), 9.4%. Significantly the lowest mean age of adult AML patients was found in patients group two who had FLT3-ITD mutation only, (P=.021).The mean WBC count and blast cell percent was highest in patients with FLT3-ITD mutation than other groups. The mean platelet count in patients who had NPM1 mutations was significantly highest when compared to other groups, and it was significantly lowest in patients with FLT3-ITD mutations (P=.03). Finally, 3/3(100%) of patients harbor both NPM1 & FLT3-ITD mutations had not achieved complete hematological remission whereas 5/12(41.7%) of patients with NPM1 mutations only had achieved complete hematological remission, (P=.180).
Conclusions: FLT3-ITD mutations had been found in 20% NPM1 mutated cases. Good prognostic parameters were found in patients who had NPM1 mutations only, whereas bad prognostic parameters were found in patients who had FLT3-ITD mutation with or without NPM1 mutations. Good prognostic implications of NPM1 mutations status are superseded in FLT3-ITD positive cases which have a consistently poor prognosis.
Key words: FLT3-ITD, NPM1, Mutation, AML, Prognosis, Iraqi patients
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American Journal of Research Communication,2014, 2(8): 87-104.
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