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Table 3 Positive FLT3-ITD Risk Assessment

From: Molecular prognostic markers for adult acute myeloid leukemia with normal cytogenetics

Study

Number of FLT3 mutants/total cases studied

Treatment

Demographics of those patients with FLT3-ITD

+ FLT3-ITD assessment of risk

Fröhling, et al [21]

119/523 all comers

(22.8%)

71/224 NC AML

(32%)

AML Study Group (AMLSG)

AML HD93

AML HD98-A

- Associated with high WBC

- Associated with de novo AML

- Increased bone marrow and peripheral blood blasts

- Increased LDH

Hazard ratio (HR)

Remission duration

2.35

Kainz, et al

[23]

26/100

(26%)

16/53 NC AML

(30%)

Various protocols

- Increased in M4 (50%)

- Increased LDH

- WBC >10 K

OR

CR 0.31

Relapse rate 8.3

OS 0.17

Ciolli, et al

[24]

25/100

(25%)

Various protocols

- WBC > 30 K

- Decreased incidence of secondary AML

- Female predominance

- Increased LDH

HR

RFS 3.1

Post remission survival 2.1

Stirewelt, et al [26]

48/151

(31.8%)

Southwest Oncology Group

SWOG 9333

SWOG 9500

- High bone marrow blasts

- High peripheral blood blasts

- WBC >30 K

HR

OS 1.35

RFS 1.7

Whitman, et al [27]

23/82

(28%)

CALGB protocol

- All patients evaluated had NC AML, age <60, and de novo AML

- Median age 37 yo

- N = 8 FLT3ITD/-

No clear evidence in difference between groups, but trend towards decreased OS with FLT3ITD/-

Thiede, et al [28]

200/979

(20.4%)

Various protocols

- Increased in M5

- WBC >50 K

- Increased bone marrow blasts

OR

Mut/wt ratio 1

- all ages

OS 1.8

DFS 3.2

- age < 60

DFS 4.2

Mut/wt ratio 2

- all ages

OS 2.8

DFS 8

- age < 60

DFS6.9