The Effect Of FLT3 Mutation In Acute Promyelocytic Leukemia:A Meta-analysis

Objective:To systematically evaluate the effect of FLT3 mutation in acute promyelocytic leukemia.Methods:Search for CNKI?WanFang?VIP?CBM?PubMed?EMBase?the Cochrane Library.Then screen the studies according to the inclusion and exclusion criteria,which belonged to cohort studies and case-control study and published openly up to December 2017.The outcomes included high risk rate,complete remission rate,early mortality rate,recurrence rate,3-year overall survival rate,5-year overall survival rate,3-year disease-free-survival rate,5-year disease-free-survival rate and thrombosis rate.Revman5.3 software was used for statistical analysis after quality assessment and data extraction,with relative risk degree(RR)as an effect statistic.All the effects were expressed by 95%confidence intervals.Stata/MP14.0 software was used to conduct quantitative publication bias analysis and sensitivity analysis.Results:24 studies were included,covering a total of 2618 patients with acute promyelocytic leukemia.Meta-analysis showed that patients with FLT3-ITD mutation had lower complete remission rate(RR=0.92,95%CI(0.86,0.99),P=0.02),3-year overall survival rate(RR=0.72,95%CI(0.60,0.88),P=0.001)and 5-year overall survival rate(RR=0.89,95%CI(0.81,0.99),P=0.03),while the high risk rate(RR=3.13,95%CI(2.26,4.35),P ?0.00001),the early mortality rate(RR=2.26,95%CI(1.75,2.90),P ? 0.00001)and recurrence rate(RR=1.50,95%CI(1.11,2.02),P=0.008)were relatively high.The differences were statistically significant.There was no statistical significance of 3-year disease-free-survival rate,5-year disease-free-survival rate and thrombosis rate.And FLT3-TKD mutation had higher early mortality rate(RR=3.00,95%CI(1.74,5.20),P?0.0001),and the differences were statistically significant.While complete remission rate,recurrence rate,3-year overall survival rate,5-year overall survival rate,5-disease-free survival rate and high risk rate were not statistically significant.Conclusion:Suggests that FLT3 mutation influences the prognosis of acute promyelocytic leukemia,which contributes to the research direction of better risk stratification,better treatment and better prognosis.