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Published on: March 5, 2018
Minimal residual disease based on patient specific Flt3-ITD and -ITT mutations in acute myeloid leukemia
Sebastian Scholl1, Ivan F Loncarevic, Claudia Krause
1Department of Internal Medicine II Oncology and Hematology, Friedrich Schiller University, Erlanger Allee 101, 07740 Jena, Germany. sebastian.scholl@med.uni-jena.de
Abstract:
We present our first experiences with determination of minimal residual disease (MRD) based on patient specific Flt3-ITD (internal tandem duplication) mutations. We analysed MRD status of 11 AML patients in a retrospective investigation and its potential impact on the follow up of these patients. In five out of six patients with a positive Flt3-ITD based MRD status a relapse of AML was observed in the follow up while one patient lacks a clinical relapse so far. In contrast, four out of five patients with a negative MRD status remain free of disease. One of these patients relapsed with a switch of FAB subtype including loss of Flt3-ITD mutation. Furthermore, in one patient we could identify a Flt3-ITT (internal tandem triplication mutation).
Insights
Minimal residual disease (MRD) detection using patient-specific Flt3-ITD mutations effectively predicts Acute Myeloid Leukemia (AML) relapse. Positive MRD indicates a high likelihood of relapse, while negative MRD suggests disease-free survival.
Area of Science:
- Hematology
- Oncology
- Molecular Diagnostics
Background:
- Minimal residual disease (MRD) monitoring is crucial for Acute Myeloid Leukemia (AML) patient management.
- Flt3-ITD mutations are common in AML and can serve as targets for MRD assessment.
Purpose of the Study:
- To evaluate the feasibility and clinical impact of MRD determination using patient-specific Flt3-ITD mutations in AML.
- To correlate Flt3-ITD based MRD status with clinical outcomes, including relapse and disease-free survival.
Main Methods:
- Retrospective analysis of 11 AML patients.
- Determination of MRD status based on patient-specific Flt3-ITD mutations.
- Follow-up assessment of clinical relapse and disease status.
Main Results:
- Five of six patients with positive Flt3-ITD MRD status experienced AML relapse.
- Four of five patients with negative Flt3-ITD MRD status remained disease-free.
- One patient relapsed with a change in FAB subtype and loss of Flt3-ITD mutation; one patient had a Flt3-ITT mutation.
Conclusions:
- Patient-specific Flt3-ITD based MRD assessment is a valuable tool for predicting AML relapse.
- MRD status can guide treatment decisions and patient follow-up strategies.
- The Flt3-ITD mutation status may evolve during the course of AML.
