Real-world data on adult AML with FLT3-ITD mutation from the Thai acute leukemia working group
Year: 2025
Type: article
Study design: Observational Study
Abstract: 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.
Source: Frontiers in Oncology
Authors: Thanawat Rattanathammethee, Ekarat Rattarittamrong, Chinadol Wanitpongpun, Smith Kungwankiattichai, Weerapat Owattanapanich, Chantiya Chanswangphuwana, Chantana Polprasert, Thanakrit Piyajaroenkij, Pimjai Niparuck, Supawee Saengboon, Wasithep Limvorapitak, Panachai Silpsamrit, Kannadit Prayongratana, Chantrapa Sriswasdi, Jakrawadee Julamanee, Pirun Saelue, Aimwipa Sasakul, Dusit Jit-ueakul, Chajchawan Nakhakes, Adisak Tantiworawit
Institutions: Chiang Mai University, Khon Kaen University, Siriraj Hospital, Mahidol University, Chulalongkorn University, Ramathibodi Hospital, Thammasat University, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Prince of Songkla University, Chulabhorn Hospital, Navamindradhiraj University, Vajira Hospital, Rajavithi Hospital
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W4413834638