Allogeneic Stem Cell Transplantation Improves Survival in Patients with Acute Myeloid Leukemia Characterized by a High Allelic Ratio of Mutant FLT3-ITD
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, multicentrická studie, randomizované kontrolované studie, práce podpořená grantem
PubMed
26551637
DOI
10.1016/j.bbmt.2015.10.023
PII: S1083-8791(15)00726-0
Knihovny.cz E-zdroje
- Klíčová slova
- Acute myeloid leukemia, Allogeneic transplantation, FLT3-ITD, NPM1 mutation,
- MeSH
- akutní myeloidní leukemie * enzymologie genetika mortalita terapie MeSH
- alely * MeSH
- alografty MeSH
- dospělí MeSH
- jaderné proteiny genetika MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- mladiství MeSH
- mutace * MeSH
- nukleofosmin MeSH
- přežití po terapii bez příznaků nemoci MeSH
- transplantace kmenových buněk * MeSH
- tyrosinkinasa 3 podobná fms genetika MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- Názvy látek
- FLT3 protein, human MeSH Prohlížeč
- jaderné proteiny MeSH
- NPM1 protein, human MeSH Prohlížeč
- nukleofosmin MeSH
- tyrosinkinasa 3 podobná fms MeSH
Allogeneic hematopoietic cell transplantation (alloHCT) as a postremission therapy in patients with FLT3-ITD-positive intermediate-risk acute myeloid leukemia (AML) remains controversial. FLT3-ITD mutations are heterogeneous with respect to allelic ratio, location, and length of the insertion, with a high mutant-to-wild-type ratio consistently associated with inferior prognosis. We retrospectively analyzed the role of alloHCT in first remission in relationship to the allelic ratio and presence or absence of nucleophosmin 1 mutations (NPM1) in the Study Alliance Leukemia AML2003 trial. FLT3-ITD mutations were detected in 209 patients and concomitant NPM1 mutations in 148 patients. Applying a predefined cutoff ratio of .8, AML was grouped into high- and low-ratio FLT3-ITD AML (HR(FLT3-ITD) and LR(FLT3-ITD)). Sixty-one patients (29%) were transplanted in first remission. Overall survival (OS) (HR, .3; 95% CI, .16 to .7; P = .004) and event-free survival (EFS) (HR, .4; 95% CI, .16 to .9; P = .02) were significantly increased in patients with HR(FLT3-ITD) AML who received alloHCT as consolidation treatment compared with patients who received consolidation chemotherapy. Patients with LR(FLT3-ITD) AML and wild-type NPM1 who received alloHCT in first remission had increased OS (HR, .3; 95% CI, .1 to .8; P = .02) and EFS (HR, .2; 95% CI, .1 to .8; P = .02), whereas alloHCT in first remission did not have a significant impact on OS and EFS in patients with LR(FLT3-ITD) AML and concomitant NPM1 mutation. In conclusion, our results provide additional evidence that alloHCT in first remission improves EFS and OS in patients with HR(FLT3-ITD) AML and in patients with LR(FLT3-ITD) AML and wild-type NPM1.
Abteilung für Hämatologie Onkologie und Palliativmedizin Robert Bosch Krankenhaus Stuttgart Germany
Department of Hemato Oncology University Hospital Brno CEITEC Masaryk University Brno Czech Republic
Klinik für Innere Medizin 3 Klinikum Chemnitz gGmbH Chemnitz Germany
Klinik und Poliklinik für Innere Medizin 3 Universitätsklinikum Regensburg Regensburg Germany
Medizinische Klinik 2 Universitätsklinikum Frankfurt Goethe Universität Frankfurt Germany
Medizinische Klinik und Poliklinik 1 TU Dresden Dresden Germany
Medizinische Klinik und Poliklinik 2 Universitätsklinikum Würzburg Würzburg Germany
Medizinische Klinik und Poliklinik A Universitätsklinikum Münster Münster Germany
Citace poskytuje Crossref.org
