Detection of FLT3 Gene Mutations In Patients With Acute Myeloid Leukemia In Surabaya, Indonesia: A Single-Center Study

Background: FLT3 gene mutation contributes worse prognosis in patients with acute myeloid leukemia (AML). Almost 67% of patients with AML with FLT3 gene mutation cannot reach complete remission after induction therapy, and they are also at high risk of relapse. We aimed to investigate the FLT3-ITD, -TKD (D835) gene mutation prevalence in patients with AML at Surabaya and their association with leukocyte and bone marrow blast cell count. Methods: 20 de novo patients with AML were recruited during February–July 2018. They were investigated through routine AML check-up and detection for FLT3-ITD, -TKD (D835) gene mutation. Results: Four patients with de novo AML (20%) had FLT3-ITD gene mutation, and one patient had FLT3-TKD (D835) gene mutation. Median leukocyte count in patients with AML with FLT3-ITD mutation was higher than wild type patients ( 146.3×103/ µL vs 16.4 x 103 / µL, P=0,002). The mean bone marrow blast cell count was higher in patients with AML with FLT3-ITD mutation than wild type patients ( 86.5% vs 57.9%, P=0,047). The difference in leukocyte and bone marrow blast cell count in patients with FLT3-TKD (D835) mutation could not be analyzed since there was only one patient with this mutation. Conclusion: The prevalence of FLT3-ITD gene mutation in patients in AML in Surabaya was 20% and FLT3-TKD (D835) was 5%. Patients with FLT3-ITD gene mutation was associated with leukocyte and bone marrow blast cell count.