The Clinical Outcome of Patients With Acute Myeloid Leukemia Expressing FLT3 Internal Tandem Duplication Mutations Could Be Altered by Treatment Regimen

Several studies have now reported the association of FLT3 internal tandem duplication (FLT3/ITD) mutations and FLT3 D835 point mutations with poor prognosis in acute myeloid leukemia (AML). Chemotherapy regimens used in these studies have varied but in most cases contain combinations of anthracyclines and Ara C. Thus far, no specific treatment regimen has been identified that is capable of impacting on the poor outcomes seen with these mutations. In this study, we analyzed the diagnostic bone marrow samples of patients with AML from 2 separate institutions for the presence of FLT3/ITD and D835 point mutations. When comparing the clinical characteristics and outcomes with respect to FLT3/ITD mutations, clear differences in the rates of complete remission (CR) and overall survival (OS) between the 2 groups of patients were observed. These 2 institutions used different induction and consolidation strategies for their patients, suggesting that some treatment regimens have greater efficacy in this poor-risk subset of patients with AML. Further study of this issue is warranted.