The Impact of Flt3 Gene Mutations in Acute Promyelocytic Leukemia: A Meta-Analysis

被引:32
作者
Picharski, Gledson L. [1 ,2 ]
Andrade, Diancarlos P. [1 ,2 ]
Fabro, Ana Luiza M. R. [1 ,2 ,3 ]
Lenzi, Luana [1 ,4 ]
Tonin, Fernanda S. [4 ]
Ribeiro, Raul C. [5 ]
Figueiredo, Bonald C. [1 ,2 ,6 ,7 ]
机构
[1] Inst Pesquisa Pele Pequeno Principe, 1532 Silva Jardim, BR-80250200 Curitiba, Parana, Brazil
[2] Fac Pequeno Principe, 333 Iguacu Av, BR-80230902 Curitiba, Parana, Brazil
[3] Pequeno Principe Hosp, Unidade Hematol & Oncol, 1070 Dsembargador Motta Av, BR-80250060 Curitiba, Parana, Brazil
[4] Univ Fed Parana, 632 Pref Lothario Meissner Av, BR-80210170 Curitiba, Parana, Brazil
[5] St Jude Childrens Res Hosp, Dept Oncol, Leukemia & Lymphoma Div, 262 Danny Thomas Pl, Memphis, TN 38105 USA
[6] Ctr Genet Mol & Pesquisa Canc Criancas CEGEMPAC, 400 Agostinho Leao Jr Av, BR-80030110 Curitiba, Parana, Brazil
[7] Univ Fed Parana, Dept Saide Colet, 260 Padre Camargo St, BR-80060240 Curitiba, Parana, Brazil
关键词
acute promyelocytic leukemia; APL; FLT3-ITD; FLT3-D835; WBC; TRANS-RETINOIC ACID; ACUTE MYELOID-LEUKEMIA; INTERNAL TANDEM DUPLICATION; ARSENIC TRIOXIDE; PROGNOSTIC VALUE; CONFERS POOR; THERAPY; CONSOLIDATION; ASSOCIATION;
D O I
10.3390/cancers11091311
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The association of FLT3 mutations with white blood cell (WBC) counts at diagnosis and early death was studied in patients with acute promyelocytic leukemia (APL). Publications indexed in databases of biomedical literature were analyzed. Potential publication bias was evaluated by analyzing the standard error in funnel plots using the estimated relative risk (RR). Mixed-effect models were used to obtain the consolidated RR. All analyses were conducted using the R statistical software package. We used 24 publications in the final meta-analysis. Of 1005 males and 1376 females included in these 24 publications, 645 had FLT3-ITD (internal tandem duplication) mutations. Information on FLT3-D835 mutations was available in 10 publications for 175 patients. Concurrent occurrence of the two mutations was rare. WBC count at diagnosis was >= 10 x 10(9)/L in 351 patients. For patients with the FLT3-ITD mutation, RR was 0.59 for overall survival (OS) and 1.62 for death during induction. For those with FLT3-D835 mutations, the RR was 0.50 for OS and 1.77 for death during induction. RR for WBC count >= 10 x 10(9)/L was 3.29 and 1.48 for patients with FLT3-ITD and FLT3-D835, respectively. APL patients with FLT3-ITD or FLT3-D835 are more likely to present with elevated WBC counts and poorer prognosis than those without these mutations.
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页数:14
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