Clinical Implications of Molecular markers in Acute Myeloid Leukemia- A Single Centre Prospective Study
DOI:
https://doi.org/10.64149/J.Carcinog.24.4.250-260Keywords:
Study Population and Sample Size, Baseline Assessment and Molecular Profiling.Abstract
Background: Acute myeloid leukemia (AML) represents a heterogeneous group of hematologic malignancies where molecular markers play an increasingly crucial role in risk stratification and treatment decisions. This study evaluated the clinical implications of molecular markers in AML patients treated with standard induction chemotherapy.
Methods: This prospective observational study enrolled 44 adult AML patients treated with standard 3+7 induction regimen over 18 months. Comprehensive molecular profiling including FLT3, NPM1, CEBPA, and other mutations was performed at diagnosis. Post-induction bone marrow assessment and minimal residual disease (MRD) evaluation were conducted. Clinical outcomes including complete remission rates, duration of hospitalization, and survival were analyzed in relation to molecular markers.
Results: Among 44 patients (median age 30 years, 56.8% males), molecular mutations were detected in 56.8% of cases. NPM1 mutations (20.4%) and FLT3 mutations (15.9%) were most frequent. Complete remission was achieved in 72.1% of patients, with median time to remission of 27 days. Patients with favorable-risk markers (27.3%) showed superior remission rates compared to high-risk patients (20.5%). Infectious complications occurred in 63.6% of patients, with 40.9% requiring ICU admission. The presence of FLT3-ITD was associated with lower remission rates and increased treatment-related toxicity.
Conclusion: Molecular markers significantly influence treatment outcomes in AML. Integration of comprehensive molecular profiling at diagnosis enables risk-adapted treatment strategies and improves prognostication. Early MRD assessment post-induction provides valuable information for subsequent treatment decisions.
