Acute Myeloid Leukemia (AML) is a malignant clonal hematological, marked by clonal proliferation neoplasm cells of the myeloid lineage in the bone marrow, characterized by presence of different genetic alterations. Variants in the FLT3 gene (FMS-like tyrosine kinase 3) are related with development of the disease, FLT3 mutation is present in 10-35% of the AML cases. FLT3 variants influence in the origin of aggressive and resistant clones related worse survival outcome when not treated adequately.

To evaluate the clinical profile and survival of the AML patients accord FLT3 status and cytogenetics features in the Hematology and Hemotherapy Foundation of the Amazonas State (HEMOAM).

Was performed prospective study with AML patients over 18 years old, proceeding Amazonas state, treated between January/2022 to October/2023 in the HEMOAM. The cytogenetic analysis was performed by G band and FLT3 variants screening in the 8-24 exons by nucleotide sequencing. Survival analysis was by Kaplan-Meirer, and Log-rank test, the median follow-up was 400 days.

A total of 29 AML patients were included with median 42 years (28-69 years), being 17 (59%) female patients. Chromosomal alteration was prevalent in 19 (66%) of the AML patients, 4 (14%) classified as favorable risk, 21 (72%) intermediary and 4 (14%) as adverse risk. Different FLT3 variants were identified, FLT3-ITD present in 5 (17.3%) patients and missense variants in 7 (24.1%) of the cases. From patients evaluated, 17 (59%) died and 12 (41%) survived until the end of the research, with a median survival of 150 days. Although, patients with missense variants present shorter survival time (110 days) when compared with FLT3 negative and FLT3-ITD+, 439 and 142.5 days, respectively. That patients classified as intermediary risk presented shorter survival time (110 days) when compared with favorable and adverse.

Here, female patients and young subjects were most prevalent in the study population, different features when compared to global data. The mortality rate was elevated (59%). FLT3 variants are frequently observed in AML patients, which in this study the missense variants were more prevalent (24.1%). FLT3 mutation and cytogenetic changes contribute to risk stratification and treatment direction. That patients carrier some FLT3 variant present lower survival time, as observed to missense variants.

Despite the low sample size, our data suggests a possible trend of the FLT3 status with unfavorable clinical outcome, highlighting the missense variants and genomic alterations.