{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T07:59:24Z","timestamp":1761292764738,"version":"build-2065373602"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2010,11,29]],"date-time":"2010-11-29T00:00:00Z","timestamp":1290988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2011,5,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>ABCG2 protein overexpression and <jats:italic>FLT3<\/jats:italic> internal tandem duplication (ITD) correlate with higher relapse rate and shorter disease\u2010free survival (DFS) in acute myeloid leukemia (AML), but no data are available on the possible effect of concomitant presence of these 2 factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>The authors analyzed the outcome of 166 cases of adult AML patients who were homogeneously treated with a fludarabine\u2010based induction therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>ABCG2 overexpression and <jats:italic>FLT3<\/jats:italic>\u2010ITD were detected in 83 (50%) and 47 (28%) patients, respectively. A significant correlation was found between ABCG2 positivity and <jats:italic>FLT3<\/jats:italic> mutation, with 33 (40%) ITD in 83 ABCG2\u2010positive patients compared with 14 (17%) ITD in 83 ABCG2\u2010negative patients (<jats:italic>P<\/jats:italic> = .002). Complete remission (CR) after induction therapy was achieved in 95 (57%) patients. Neither ABCG2 overexpression nor <jats:italic>FLT3<\/jats:italic>\u2010ITD had any impact on achievement of CR. Relapse occurred in 42 of 95 (44%) patients at a median time of 28 months. Time to relapse was shortened in patients overexpressing ABCG2 (<jats:italic>P<\/jats:italic> = .0004). DFS was not affected by <jats:italic>FLT3<\/jats:italic>\u2010ITD alone, but <jats:italic>FLT3<\/jats:italic> mutation significantly worsened long\u2010term outcome of ABCG2\u2010positive patients. DFS at 1 and 3 years in patients with overexpression of both ABCG2 and <jats:italic>FLT3<\/jats:italic>\u2010ITD was only 36% and 28%, respectively; in ABCG2\u2010positive\/<jats:italic>FLT3<\/jats:italic>\u2010negative patients, DFS at 1 and 3 years was 65% and 48%, respectively; and in ABCG2\u2010negative cases (regardless of <jats:italic>FLT3<\/jats:italic> status), DFS at 1 and 3 years was greater than 85% and 75%.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Concomitant overexpression of ABCG2 and <jats:italic>FLT3<\/jats:italic>\u2010ITD is relatively frequent and identifies a subgroup of AML patients with a significantly worse prognosis. The possible interactions between these 2 prognostic factors need to be defined. Cancer 2011. \u00a9 2010 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.25753","type":"journal-article","created":{"date-parts":[[2010,11,29]],"date-time":"2010-11-29T12:22:42Z","timestamp":1291033362000},"page":"2156-2162","source":"Crossref","is-referenced-by-count":18,"title":["Concomitant ABCG2 overexpression and <i>FLT3<\/i>\u2010ITD mutation identify a subset of acute myeloid leukemia patients at high risk of relapse"],"prefix":"10.1002","volume":"117","author":[{"given":"Mario","family":"Tiribelli","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Geromin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Michelutti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margherita","family":"Cavallin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annalisa","family":"Pianta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dora","family":"Fabbro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenico","family":"Russo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Damante","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato","family":"Fanin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Damiani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,11,29]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909303411407"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2404692"},{"key":"e_1_2_6_4_2","first-page":"3323","article-title":"Acute myeloid leukemia in the elderly: assessment of multidrug resistance (MDR1) and cytogenetics distinguishes biologic subgroups with remarkably distinct responses to standard chemotherapy","volume":"89","author":"Leith CP","year":"1997","journal-title":"A Southwest Oncology Group study. 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