Fms Like Tyrosine Kinase (FLT3) and Nucleophosmin 1 (NPM1) Mutations in De Novo Normal Karyotype Acute Myeloid Leukemia (AML)

Abstract

Mutations in FLT3 and NPM1 are important prognostic factors in AML, influencing outcome in normalkaryotype cases. We here analysed incidences of FLT3/ITD, D 835 and NPM1 mutations in patients with denovo normal karyotype AML using PCR and gene sequencing, along with laboratory parameters and treatmentoutcomes. There were 128 patients with a median age of 45 years (range, 19-65). FLT3/ITD mutations weredetected in 26 (20.3%), FLT3/D835 in 8 (6.2%) and NPM1 in 22 (17.1%). The incidence of FLT3/ITD was higherin those with elevated lactate dehydrogenase (LDH) and peripheral blasts (p=< 0.002, < 0.001) while NPM1mutations or both NPM1 and FLT3/ITD was more common in elevated total leukocyte counts (TLC), LDH andperipheral blasts (p=<0.0001). Complete response and disease free survival were lower in those with FLT3/ITDmutations (p=0.04, 0.03). The incidence of FLT3 and NPM1 mutations was found to be low in Indian patientswith normal karyotype AML.