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FLT3 Mutations Mark Poor Prognosis in Pediatric Leukemia

Allelic ratio greater than 0.4 a prognostic factor for relapse

FRIDAY, Dec. 8 (HealthDay News) -- Mutations in the FLT3 gene are significantly associated with relapse in pediatric acute myeloid leukemia, according to study findings published in the Dec. 1 issue of Blood.

Soheil Meshinchi, M.D., Ph.D., of the Fred Hutchinson Cancer Research Center in Seattle, and colleagues determined the FLT3 mutation status and progression-free survival in 630 children with de novo acute myeloid leukemia (AML). Mutations in FLT3 commonly occur in AML and usually appear as internal tandem duplications (FLT3/ITD) or activating point mutations in the loop domain (FLT3/ALM).

Patients with the FLT3/ITD had lower four-year progression-free survival than those with either no FLT3 mutation or FLT3/ALM (31, 55, and 51 percent, respectively). In addition, an allelic ratio of FLT3/ITD greater than 0.4 was associated with significantly worse progression-free survival.

"Identification of patients with FLT3 mutations at high risk of relapse as well as appropriate therapeutic intervention may improve outcome in this high-risk population," the authors write.

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