ABSTRACT
PURPOSE: To evaluate the influence of FLT3-ITD mutations on the treatment response and long-term survival of newly-diagnosed patients with acute promyelocytic leukemia (APL) treated with all-trans retinoic acid and arsenic trioxide. METHODS: The long-term survival of 90 newly-diagnosed APL patients (age range 12-75 years) was retrospectively analyzed.The FLT3-ITD mutation rate was assayed by polymerase chain reaction (PCR) amplification and sequencing analysis. Its impact on the treatment response, event-free survival(EFS), or overall survival(OS) was investigated in patients with and without the mutations. RESULTS: The FLT3-ITD mutation rate in newly-diagnosed APL patients was 20% (18/90). The white blood cell (WBC) count at diagnosis in patients with mutations was significantly higher than that in patients without mutations while the FLT3-ITD mutation rate was higher in the high-risk group than in the low/intermediate-risk group. Patients with mutations had a significantly higher early death (ED) rate (16.67% vs 1.39%) for those lacking the mutation (P =0.024). However, the complete remission (CR) and differentiation syndrome (DS) rates in the two groups were similar. Kaplan Meier analysis for EFS and OS at five years showed a significant difference between the patients stratified by FLT3-ITD mutation status (log-rank P =0.010 and P =0.009, respectively). CONCLUSION: FLT3-ITD mutations can be related to high peripheral WBC counts in APL patients. APL patients with mutations displayed a higher ED rate compared to those without mutations. Patients carrying mutations had reduced five-year EFS and OS rates. Thus, reducing the overall death rate during induction treatment might be an effective way to improve the prognosis of patients with FLT3-ITD mutations.
ABSTRACT
Acute basophilic leukemia (ABL), as a rare form of acute myeloid leukaemia (AML) accounts for <1% of cases of AML. ABL has not been detected for encouragingly specific targets. Here we report a de novo fragile ABL case treated with decitabine based regimen with transient response even if overall survival was a 3-month. The case of a 79-year-old male who was complained of fever, rashes and cytopenia is reported in the current study. The diagnosis of ABL was identified due to characteristic cytomorphological features and immunophenotype of myeloid blast cells without the Philadelphia chromosome. The patient initially presented with short-term improvement with decitabine. Combination of decitabine and arsenic trioxide in second chemotherapy regimen didn't reverse the end of death with a 3 months overall survival. In conclusion, our study revealed that decitabine may be an efficient therapeutic option in ABL patients and warranted much more exploration in use.
ABSTRACT
Fatty acid synthase (FASN) is a common phenotype to many kinds of human cancers, such as those of the breast, ovary, pancreas, prostate, colon, and so on. Increased FASN levels have been detected in the serum of the patients with breast and pancreatic cancers. The relationship between the FASN level in serum and the clinicopathological characteristics of colorectal cancer is investigated in this study. FASN levels in serum were examined with enzyme-linked immunosorbent assay (ELISA) in 74 patients with colorectal cancer and 40 healthy persons. Pathological and clinical factors associated with FASN concentrations in serum were investigated and analyzed by statistical analysis. The FASN level in colorectal cancer patients' serum is significantly higher than that in healthy persons' serum. FASN levels in the serum of colorectal cancer patients are associated with tumor extent, lymph node metabasis status, distant metastasis, and tumor clinical stage. The 5-year overall survival rate and 5-year disease-free survival rate among patients with low FASN levels in serum are significantly higher than those among patients with high FASN levels in serum (log-rank P = 0.003). The high FASN level in serum is a promising independent predictor of colorectal cancers with advanced phases, late clinical stages, and shorter survival. These results suggest that FASN concentration in serum may be a potential and useful tumor marker.
