BCRP mRNA and FLT3 ‐ITD are independent poor risk factors in adult patients with acute myeloid leukemia and intermediate or normal karyotype

Purpose FMS ‐like tyrosine kinase 3‐internal tandem duplication ( FLT 3 ‐ ITD ) is aberration associated with poor prognosis in AML . We have analyzed the expression of MDR ‐1 , MRP ‐1 , and BCRP   mRNA in relation to FLT 3 ‐ ITD in 100 AML adult patients with normal and intermediate karyotype. Methods The RQ ‐ PCR method was performed to assess the expression of MDR ‐1 , MRP ‐1 , and BCRP   mRNA , and the results were presented as coefficients calculated using an intermediate method according to Pfaffl's rule. Results According to univariate analysis, the following pretreatment variables negatively influenced disease‐free survival ( DFS ): WBC count ≥25×10 9 /L ( P =.037), MRP ‐1 mRNA ≥1.6818 ( P =.028), BCRP   mRNA ≥1.1892 ( P =.004), FLT 3 ‐ ITD ( P =.005) and overall survival ( OS ): WBC count ≥25×10 9 /L ( P =.031), MRP ‐1 mRNA ≥1.6818 ( P =.01), BCRP   mRNA ≥1.1892 ( P =.01), FLT 3 ‐ ITD ( P =.001). When all prognostic variables were pooled into a multivariate model, we found that WBC count ≥25×10 9 /L ( P =.026) and BCRP   mRNA ≥1.1892 ( P =.011). We observed trend in negative influence of FLT3 ‐ITD on DFS ( P =.057). BCRP   mRNA ≥1.1892 ( P =.035) and FLT 3 ‐ ITD ( P =.006) negatively, independently influenced the OS . Conclusions The high expressions of BCRP   mRNA calculated with Pfaffl's rule and FLT 3 ‐ ITD are independent poor risk factors in adult patients with AML and intermediate or normal karyotype.