Prognostic value of internal tandem duplication of the FLT3 gene in childhood acute myelogenous leukemia

Masaru Kondo, Keizo Horibe, Yoshiyuki Takahashi, Kimikazu Matsumoto, Minoru Fukuda, Jun Inaba, Koji Kato, Seiji Kojima, Takaharu Matsuyama

研究成果: ジャーナルへの寄稿学術誌査読

145 被引用数 (Scopus)


Background. Recently, an internal tandem duplication of the FLT3 gene (FLT3/ITD) was found in 20% of adult cases of acute myelogenous leukemia (AML), and this length abnormality was suggested to be associated with leukemic progression. Procedure. We examined the mRNA expression of the FLT3 gene by using reverse transcription-polymerase chain reaction (RT-PCR) in 64 children with AML, and further abnormal transcripts were cloned and sequenced. Results. An unexpected longer product was found in seven patients (11%) by RT-PCR of the FLT3 gene. Sequence analysis of these abnormal products revealed the presence of tandemly duplicated fragments in all seven patients. Three factors were identified to be associated with high incidence of FLT3/ITD; older patients (≥10 years) (P = 0.049), high WBC count (≥50,000/μl) at presentation (P = 0.002), and M3 in FAB subtypes (P = 0.002). Induction failure was observed in 3 (43%) of 7 patients with FLT3/ITD. Only FLT3/ITD was identified as a significant risk factor for induction failure by univariate analysis (P = 0.013), although it was not significant by multivariate analysis (P = 0.11). The Kaplan-Meier estimate of event-free survival rate at 5 years was 14% for patients with FLT3/ITD, which was significantly lower in comparison with 69% for patients without FLT3/ITD (P = 0.003). This finding was also identified by multivariate analysis (P = 0.01). Conclusions. In this study, FLT3/ITD was observed in 11% of childhood AML and identified to be associated with poor prognosis. A large prospective study with uniform treatment is necessary to confirm our results.

ジャーナルMedical and Pediatric Oncology
出版ステータス出版済み - 12月 1999

!!!All Science Journal Classification (ASJC) codes

  • 小児科学、周産期医学および子どもの健康
  • 腫瘍学
  • 癌研究


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