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Updated: May 5, 2026
Next Generation Sequencing for the Detection of Actionable Mutations in Solid and Liquid Tumors
Published on: September 20, 2016
Real-world data on adult AML with FLT3-ITD mutation from the Thai acute leukemia working group
Thanawat Rattanathammethee1, Ekarat Rattarittamrong1, Chinadol Wanitpongpun2
1Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Background:
FLT3-ITD mutations are among the most common genetic alterations in acute myeloid leukemia (AML) and are associated with poor clinical outcomes. However, data from low- and middle-income countries remain limited. This study aimed to investigate the prevalence, clinical characteristics, treatment patterns, and outcomes of adult AML patients with FLT3-ITD mutations in Thailand.
Methods:
We analyzed data from 360 adult patients with newly diagnosed AML, prospectively collected from 11 institutions nationwide between 2016 and 2023. FLT3-ITD mutational status, clinical features, response to therapy, and survival outcomes were compared between FLT3-ITD and FLT3-wild-type patients.
Results:
FLT3-ITD mutations were detected in 28.1% of patients. FLT3-ITD patients had higher white blood cell counts, bone marrow blast percentages, and NPM1 co-mutations compared to wild-type FLT3. Induction chemotherapy rates were similar, but FLT3 inhibitor use was nearly absent. Complete remission was achieved in 55.7% of FLT3-ITD patients versus 66.5% in wild-type FLT3. Median overall survival was significantly shorter in the FLT3-ITD group (8.8 vs. 13.2 months, p=0.039), while relapse-free survival was not significantly different. Multivariable analysis confirmed FLT3-ITD mutation as an independent predictor of poor overall survival.
Conclusions:
In this nationwide real-world study, FLT3-ITD AML was associated with inferior outcomes despite comparable induction therapy. Limited access to FLT3-targeted treatments and stem cell transplantation may contribute to these disparities. Our findings highlight the urgent need for expanding access to molecular testing and targeted therapies in resource-limited settings.
Insights
FLT3-ITD mutations in acute myeloid leukemia (AML) patients in Thailand were linked to worse survival outcomes. Limited access to targeted therapies may explain these disparities, emphasizing the need for improved molecular testing and treatment access in resource-limited settings.
Area of Science:
- Hematology
- Oncology
- Molecular Diagnostics
Background:
- FLT3-ITD mutations are common in acute myeloid leukemia (AML) and linked to poor prognosis.
- Data on FLT3-ITD mutations in low- and middle-income countries, like Thailand, are scarce.
- Understanding the prevalence and impact of FLT3-ITD in Thailand is crucial for improving patient outcomes.
Purpose of the Study:
- To determine the prevalence of FLT3-ITD mutations in adult AML patients in Thailand.
- To analyze the clinical characteristics, treatment patterns, and outcomes associated with FLT3-ITD mutations.
- To compare outcomes between FLT3-ITD positive and FLT3-wild-type AML patients in a real-world setting.
Main Methods:
- Prospective data collection from 360 adult AML patients across 11 Thai institutions (2016-2023).
- Analysis of FLT3-ITD mutational status, clinical features, and treatment response.
- Comparison of survival outcomes (overall survival, relapse-free survival) between FLT3-ITD and FLT3-wild-type groups.
Main Results:
- FLT3-ITD mutations were found in 28.1% of patients, associated with higher WBC counts and blast percentages.
- FLT3-ITD patients had significantly shorter median overall survival (8.8 vs. 13.2 months) compared to wild-type.
- FLT3 inhibitor use was minimal, and complete remission rates were lower in the FLT3-ITD group (55.7% vs. 66.5%).
Conclusions:
- FLT3-ITD AML in Thailand is associated with inferior survival outcomes despite similar induction chemotherapy.
- Limited access to FLT3-targeted therapies and stem cell transplantation likely contributes to outcome disparities.
- There is an urgent need to expand access to molecular testing and targeted therapies in resource-limited settings.
