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Blood, 1 May 2006, Vol. 107, No. 9, pp. 3724-3726.
Prepublished online as a Blood First Edition Paper on December 20, 2005; DOI 10.1182/blood-2005-08-3453.


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NEOPLASIA
Brief report

Size of FLT3 internal tandem duplication has prognostic significance in patients with acute myeloid leukemia

Derek L. Stirewalt, Kenneth J. Kopecky, Soheil Meshinchi, Julia H. Engel, Era L. Pogosova-Agadjanyan, Jeremy Linsley, Marilyn L. Slovak, Cheryl L. Willman, and Jerald P. Radich

From the Clinical Research Division and the Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA; the Division of Oncology, University of Washington, Seattle; the Children's Oncology Group, Myeloid Disease Committee, Arcadia, CA; the Department of Cytogenetics, City of Hope National Medical Center, Duarte, CA; and the Department of Pathology and Cell Biology, University of New Mexico School of Medicine, Albuquerque.

FLT3 internal tandem duplications (FLT3/ITDs) in the juxtamembrane domain are found in approximately 25% of acute myeloid leukemia (AML) patients, ranging in size from 3 to hundreds of nucleotides. We examined whether the sizes of FLT3/ITDs were associated with clinical outcomes in 151 AML patients enrolled in Southwest Oncology Group studies: S9333 and S9500. FLT3/ITDs were identified in 32% of patients (median ITD size = 39 nucleotides; range, 15-153 nucleotides). The CR rates were 35%, 67%, and 52% for patients with large (≥ 40), small (< 40), and no ITDs, respectively (P = .19). Increasing ITD size was associated with decreasing OS (estimated 5-year OS: large = 13%, small = 26%, and no ITD = 21%, P = .072) and RFS (estimated 5-year RFS: large = 13%, small = 27%, and no ITD = 34%, P = .017). These studies suggest that ITD size may have prognostic significance.


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