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FLT3-ITD Mutation and FLT3 Ligand Plasma Level Were Not Associated with One-Year Survival of Indonesian Acute Myeloid Leukemia Patients

Authors Rinaldi I, Louisa M, Mulya Sari R, Arwanih E

Received 19 September 2020

Accepted for publication 23 December 2020

Published 26 February 2021 Volume 2021:14 Pages 1479—1486

DOI https://doi.org/10.2147/OTT.S282842

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr William Cho


Ikhwan Rinaldi,1 Melva Louisa,2 Resti Mulya Sari,3 Elly Arwanih1

1Division of Hematology and Medical Oncology, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; 2Department of Pharmacology and Therapeutics, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; 3Division of Hematology and Medical Oncology, Department of Internal Medicine, Dharmais Cancer Hospital,Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia

Correspondence: Ikhwan Rinaldi
Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
Email [email protected]

Objective: To analyze the association of FLT3-ITD mutation and FLT3 ligand plasma level with one-year survival of Indonesian acute myeloid leukemia (AML) patients.
Methods: A prospective cohort study was conducted to determine the association between FLT-3-ITD mutation and FLT3 ligand plasma level with one-year survival of Indonesian AML patients. In the study, a total of 51 AML patients were obtained from two tertiary hospitals in Indonesia from year 2018 to 2020. Inclusion criteria were de novo AML male and female patients aged ≥ 18 years old. Exclusion criteria were prior myelodysplastic syndrome and patients that refused to participate in the study. FLT3-ITD genotype of patients was then analyzed using PCR method while FLT3 ligand plasma level was measured using ELISA method. Patients were then followed-up for 1 year or until death occurred with survival as the measured outcome. Association between independent and dependent variable were analyzed by cox regression proportional hazard.
Results: Eleven patients (21.5%) in this study had FLT3-ITD mutation. The median age of AML patients was 45 (18– 71) years, and the median blast percentage was 50% (5– 87%). After one-year follow-up, 33 (64.7%) patients had died. The median survival of AML patients was 6 months. Univariate analysis showed no association between FLT3-ITD mutation status (HR: 1.051 ; 95% CI: 0.483– 2.286; P: 0.901) and FLT3 ligand plasma level (HR: 0.798; 95% CI: 0.347– 1.837; p= 0.596), and age (HR: 1.283; 95% CI: 0.575– 2.862; p= 0.542) with one-year survival of AML patients, but multivariate analysis showed association between GFR with one-year survival of AML patients in this cohort (HR: 4.053; 95% CI: 1.469– 11.183; p= 0.007).
Conclusion: One-year survival of AML patients in Indonesia is not affected by FLT3-ITD mutation and FLT3 ligand plasma level. However, GFR showed association with one-year survival of AML patient in this cohort study.

Keywords: acute myeloid leukemia, one-year survival, FLT3-ITD, FLT3 Ligand Plasma

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