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. 2020 Oct 16:13:867-879.
doi: 10.2147/IJGM.S276138. eCollection 2020.

Combined Expression of CD34 and FLT3-Internal Tandem Duplication Mutation Predicts Poor Response to Treatment in Acute Myeloid Leukemia

Mona S Abdellateif  1 , Amira B Kassem  2 , Yomna M El-Meligui  3
Affiliations

Combined Expression of CD34 and FLT3-Internal Tandem Duplication Mutation Predicts Poor Response to Treatment in Acute Myeloid Leukemia

Mona S Abdellateif et al. Int J Gen Med. .

Abstract

Background: Acute myeloid leukemia (AML) is a common hematological malignancy associated with different cytogenetic and genetic abnormalities.

Methods: FLT3-internal tandem duplication (FLT3/ITD) mutation and CD34 expression levels were assessed in the bone marrow (BM) aspirates of 153 de novo AML patients. Data were correlated with relevant clinic-pathological features of the patients, response to treatment, disease-free survival (DFS), and overall free survival (OS) rates.

Results: FLT3-ITD mutation was detected in 27/153 (17.6%) AML patients (P=0.001), and CD34 was expressed in 83/153 (54.2%) patients (P=0.293) compared to those with wild FLT3 and CD34- expression, respectively. Patients with FLT3-ITD mutation showed increased peripheral blood and BM blast cells, abnormal cytogenetics, poor DFS and OS compared to those with wild FLT3 (P=0.013, P<0.001, P=0.010, P=0.008 and P=0.004, respectively), while there was no significant association with response to treatment (P=0.081). There was no significant association between CD34 expression and response to treatment, DFS, and OS (P>0.05). FLT3-ITD mutation and FAB subtypes were independent prognostic factors for DFS. Older age ≥39 years, HB <7 mg/dL PB blast ≥54%, and FLT3-ITD mutation were independent prognostic factors for poor OS in AML patients. The presence of both FLT3-ITD mutation and CD34 expression associated significantly with resistance to therapy (P=0.024), short DFS and OS rates (P=0.006, P=0.037, respectively).

Conclusion: Combined expression of both FLT3-ITD mutation and CD34 expression is an important prognostic and predictive factor for poor disease outcome in AML patients.

Keywords: AML; CD34; FLT3-ITD; acute myeloid leukemia.

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Conflict of interest statement

All authors declare that there are no conflicts of interest.

Figures

Figure 1
Figure 1
Flow histogram shows (A) negative expression of CD34 on myeloblasts, and (B) positive expression of CD34 on myeloblasts.
Figure 2
Figure 2
Expression of CD34 and FLT3-ITD gene mutation in AML patients.
Figure 3
Figure 3
Association between response to treatment and (A) FLT3-ITD gene mutation, (B) CD34 expression, and (C) different combined expression of both markers in patients’ groups.
Figure 4
Figure 4
Association between the rate of disease free survival and (A) FLT3-ITD gene mutation, (B) CD34 expression, and (C) different combined expression of both markers in patients’ groups. Association between the rate of overall survival and (D) FLT3-ITD gene mutation, (E) CD34 expression, and (F) different combined expression of both markers in patients’ groups.
See this image and copyright information in PMC

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