Background:
Molecular genotyping is an important prognostic role in acute myeloid leukemia (AML) patients. We aimed to design this meta-analysis to discuss the incidence and prognostic effect of nucleolar phosphoprotein 1 (NPM1) and Fms-like tyrosine kinase 3 gene internal tandem (FLT3-ITD) gene in AML patients.
Methods:
PubMed, Embase, Medline, and Cochrane library were systematically searched due to May 15, 2020. Four combinations of genotypes (FLT3-ITD
neg
/NPM1
mut
, FLT3-ITD
pos
/NPM1
mut
, FLT3-ITD
neg
/NPM1
wt
, FLT3-ITD
pos
/NPM1
wt
) were compared in association with the overall survival (OS) and leukemia-free survival (LFS) outcome, which expressed as pooled hazard ratio (HR) and 95% confidence intervals (CIs).
Results:
Twenty-eight studies were included in our study. The incidence of FLT3-ITD
neg
/NPM1
mut
, FLT3-ITD
pos
/NPM1
mut
, FLT3-ITD
neg
/NPM1
wt
, and FLT3-ITD
pos
/NPM1
wt
was 16%, 13%, 50%, and 10%, respectively. The patients with FLT3-ITD
neg
/NPM1
mut
gene may have the best OS and LFS when comparing with FLT3-ITD
pos
/NPM1
mut
(HR = 1.94 and 1.70,
P
< .01), FLT3-ITD
neg
/NPM1
wt
(HR = 1.57 and 2.09,
P
< .01), and FLT3-ITD
pos
/NPM1
wt
(HR = 2.25 and 2.84,
P
< .001).
Conclusion:
AML patients with FLT3-ITD
neg
/NPM1
mut
gene type have the best survival outcome than the other 3 gene types, which should be an independent genotyping in AML classification.