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Detection of FLT3 Mutations in Patients from Eastern Slovakia


Authors: Dubayová Katarína 1;  Kožlejová Zuzana 2;  Vašková Judita 3;  Čakanová Gladys 3;  Kiktavá Mária 4;  Guman Tomáš 5;  Sabo Ján 2;  Karabinos Anton 3
Authors‘ workplace: Ústav lekárskej a klinickej biochémie UPJŠ LF Košce 1;  Ústav lekárskej a klinickej biofyziky UPJŠ LF Košce 2;  SEMBID, s. r. o., Košice 3;  Oddelenie lekárskej genetiky, Medirex, a. s., Košice 4;  Klinika hematológie a onkohematológie UPJŠ LF a UNLP Košice 5
Published in: Klin Onkol 2018; 31(3): 200-206
Category: Original Articles
doi: https://doi.org/10.14735/amko2018200

Overview

Background:
The study investigated FLT3 gene mutations in patients from eastern Slovakia using a simple molecular method.

Patients and Methods:
We analyzed 141 patients with primary acute myeloid leukemia (AML) and 8 patients with AML that developed from myelodysplastic syndrome (MDS) who were aged 19–81 years. DNA isolated from peripheral blood and/or bone marrow was analyzed by PCR. FLT3 internal tandem duplication (FLT3-ITD) was detected by amplification of exons 14 and 15. Point mutations in the FLT3 tyrosine kinase domain (FLT3-TKD) were detected by digesting the PCR product of exon 20 with the restriction endonuclease EcoRV. Fragments were separated electrophoretically. PCR products of the positive samples were also analyzed using a microchip device (Bioanalyzer 2100).

Results:
LT3-ITD and point mutations in the FLT-TKD were detected in 19 and 8% of patients, resp. Two patients (1%) harbored both types of mutations. Patients with and without FLT3 mutations were called FLT+ and FLT–, resp. Most FLT3+ patients had no chromosomal aberrations (59%) or harbored the t (15; 17) translocation in PML-RARA (15%). The mortality rate was 33% among FLT3+ patients and 10% among FLT3-patients. Among FLT3+ patients, the mortality rates of patients with FLT3-ITD and point mutations of the FLT-TKD were almost the same. A 77-year-old female patient with both FLT3-ITD and a point mutation in the FLT3-TKD was in remission. The eight patients who developed AML from MDS were assessed separately. Of these, three patients were FLT3+; two patients displayed FLT3-ITD, and one patient harbored a point mutation in the FLT3-TKD. No other genetic aberrations were detected. FLT3+ patients lived for longer than FLT3-patients. These analyses of FLT3 gene mutations in patients from eastern Slovakia are consistent with published data from other databases.

Conclusion:
The applied PCR method is reliable, relatively fast, and affordable, and can be used for routine monitoring of FLT3 gene mutations. FLT3 mutations can be verified using a microchip as an alternative to capillary electrophoresis.

Key words:
acute myelogenous leukemia – DNA – PCR – mutation – FLT3-ITD – FLT3-TKD

The study was supported by the European Regional Development grant OPVaV-2009/2.2/05- -SORO (ITMS code: 26220220143).

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical paper

Submitted: 19. 10. 2017

Accepted: 15. 2. 2018


Sources

1. Vašková J, Dubayová K, Čakanová G et al. Incidence and prognostic value of known genetic aberrations in patients with acute myeloid leukemia – a two year study. Klin Onkol 2015; 28 (4): 278–283. doi: 10.14735/amko2015278.

2. Testa U, Pelosi E. The impact of FLT3 mutations on the development of acute myeloid leukemias. [online]. Leukemia Research and Treatment; 2013. Available from: http: //dx.doi.org/10.1155/2013/275760.

3. Grafone T, Palmisano M, Nicci C et al. An overview on the role of FLT3-tyrosine kinase receptor in acute myeloid leukemia: biology and treatment. Oncology Reviews 2012; 6 (1): 8e. doi: 10.4081/oncol.2012.e8.

4. Rosnet O, Schiff C, Pebusque MJ et al. Human FLT3/FLK2 gene: cDNA cloning and expression in hematopoietic cells. Blood 1993; 82 (4): 1110–1119.

5. Rosnet O, Buhring HJ, Delapayere O et al. Expression and signal transduction of the FLT3 tyrosine kinase receptor. Acta Haematol 1996; 95 (3–4): 218–223.  doi: 10.1159/000203881.

6. Griffith J, Black J, Faerman C et al. The structural basis for autoinhibition of FLT3 by the juxtamembrane domain. Mol Cell 2004; 13 (2): 169–178.

7. Abu-Duhier FM, Goodeve AC, Wilson GA et al. Identification of novel FLT-3 Asp835 mutations in adult acute myeloid leukaemia. Br J Haematol 2001; 113 (4): 983–988.

8. Yamatoto Y, Kioyi H, Nakano Y et al. Activating mutation of D835 within the activation loop of FLT3 in human hematologic malignancies. Blood 2001; 97 (8): 2434–2439.

9. Quentmeier H, Reinhardt J, Zaborski M et al. FLT3 mutations in acute myeloid leukemia cell lines. Leukemia 2003; 17 (1): 120–124. doi: 10.1038/sj.leu.2402740.

10. Whitman SP, Archer KJ, Feng I et al. Absence of the wild-type allele predicts poor prognosis in adult de novo acute myeloid leukemia with normal cytogenetics and the internal tandem duplications of FLT-3: a cancer and leukemia group B study. Cancer Res 2001; 61 (19): 7233–7239.

11. Stirewalt DL, Kopecky KJ, Meschinchi S et al. Size of FLT3 internal tandem duplication has prognostic significance in patients with acute myeloid leukemia. Blood 2006; 107 (9): 3724–3726. doi: 10.1182/blood-2005-08-3453.

12. Kayser S, Schlenk RF, Londono MC et al. Insertion of FLT3 internal tandem duplication in the tyrosine kinase domain-1 is associated with resistance to chemotherapy and inferior outcome. Blood 2009, 114 (12): 2386–2392. doi: 10.1182/blood-2009-03-209999.

13. Kioyi H, Ohno R, Ueda R et al. Mechanism of constitutive activation of FLT3 with internal tandem duplication in the juxtamembrane domain. Oncogene 2002; 21 (16): 2555–2563. doi: 10.1038/sj.onc.1205332.

14. Kusec R, Vrsalovic M, Bobetic T et al. Fms-Like Tyrosine kinase (FLT3) gene ITD mutation in acute myeloid leukemia. Zdrav Vestn 2004, 73 (supl 1): 5–7.

15. Small, D. FLT3 Mutations: Biology and Treatment. Hematology Am Soc Hematol Educ Program 2006: 178–184. doi: 10.1182/asheducation-2006.1.178.

16. Zaker F, Mohammadzadeh M, Mohammadi M. Detection of KIT and FLT3 Mutations in Acute Myeloid Leukemia with Different Subtypes. Arch Iran Med 2010; 13 (1): 21–25.

17. Daver N, Strati P, Jabbour E et al. FLT3 mutations in myelodysplastic syndrome and chronic myelomonocytic leukemia. Am J Hematol 2013; 88 (1): 56–59. doi: 10.1002/ajh.23345.

18. Takahashi S. Downstream molecular pathways of FLT3 in the pathogenesis of acute myeloid leukemia: biology and therapeutic implications. [online]. Journal of Hematology & Oncology 2011; 4: 13. Available from: https: //doi.org/10.1186/1756-8722-4-13.

19. Ilenčíková D, Sýkora J, Mikulášová Z et al. Identifikácia molekulárnych markerov u detí s akútnou myeloblastovou leukémiou (AML). Klin Onkol 2012; 25 (1): 26–35. doi: 10.14735/amko201226.

20. Meshinchi S, Appelbaum FR. Structural and functional alterations of FLT3 in acute myeloid leukemia. Clin Cancer Res 2009; 15 (13): 4263–4269. doi: 10.1158/1078-0432.CCR-08-1123.

21. Thiede C, Steudel C, Mohr B et al. Analysis of FLT3-activating mutations in 979 patients with acute myelogenous leukemia: association with FAB subtypes and identification of subgroups with poor prognosis. Blood 2002; 99 (12): 4326–4335.

22. Bagrintseva K, Geisenhof S, Kern R et al. FLT3-ITD-TKD dual mutants associated withAMLconfer resistance to FLT3 PTK inhibitors and cytotoxic agents by overexpression of Bcl-x (L). Blood 2005; 105 (9): 3679–3685. doi: 10.1182/blood-2004-06-2459.

23. Levis M. FLT3 mutations in acute myeloid leukemia: what is the best approach in 2013? Hematology Am Soc Hematol Educ Program 2013; 2013: 220–226. doi: 10.1182/asheducation-2013.1.220.

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Paediatric clinical oncology Surgery Clinical oncology
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