The Role of FLT3-ITD and CEBPA Mutations on Prognosis of Acute Lymphoblastic Leukaemia in Turkish Patients

Introduction: Acute lymphoblastic leukaemia (ALL) is the most common malignancy in childhood. Although some prognostic factors have been defined to date, estimation of prognosis is currently not perfect. Previous studies have shown an association of FLT3 with poor prognosis and CCAAT/enhancer binding protein α (CEBPA) mutation with the development of acute myeloid leukaemia (AML). Here we aimed to evaluate the prognostic value of FLT3-ITD and CEBPA mutations in ALL. Materials and Method: Sixty-one patients with ALL were included in the study. Patients were divided into three risk groups according to BFM risk classification. All of the patients were examined for FLT3-ITD mutations and 45 of them for CEBPA mutations. Mutation positive and negative patients were compared in terms of their risk groups, translocations and cell lineage. The clinical courses of the patients were appraised. Results: FLT3-ITD mutation was detected in three of 61 patients, and CEBPA mutations were detected in 11 of 45 patients. The incidence of established prognostic indicators including BFM risk classification, t(9;22);BCR-ABL, t(1;19);E2A-PBX1, t(12;21);TELAML1, t(4;11);MLL-AF4 were similar between FLT3-ITD and CEBPA positive and negative patients. A patient with an FLT3-ITD mutation was very susceptible to pancytopenia after maintenance treatment and another two patients with FLT3-ITD mutations were more prone to febrile neutropenia. Conclusion: Our results suggest that CEBPA or FLT3-ITD mutations may not be related to ALL prognosis in Turkish patients. However, FLT3-ITD mutation may have an influence on the response of bone marrow to chemotherapy.