Structural Chromosomal Changes Are Common Manifestation Of Flt3 Itd Relapse And Presence Of Chromosomal Progression Is Independent Of Normal Karyotype At Diagnosis

FLT3 ITD mutations occur in both cytogenetically normal and abnormal AML. FLT3 ITD mutated AML is associated with genomic instability and clonal evolution (Gourdin et al., Cancer Genet 2014). The most common other molecular abnormality in FLT3 ITD AML, NPM1, has been shown to participate in DNA damage response and base excision repair but its role in clonal evolution in AML is poorly characterized (Poletto et al., Mol Biol of Cell 2014). We set out to describe the characteristics of clonal evolution in FLT3 ITD AML cases treated at Johns Hopkins Hospital (JHH) over the past 15 years to characterize clinical outcomes in these leukemias.