Ho, Anthony D. and Schetelig, Johannes and Bochtler, Tilmann and Schaich, Markus and Schaefer-Eckart, Kerstin and Haenel, Mathias and Roesler, Wolf and Einsele, Hermann and Kaufmann, Martin and Serve, Hubert and Berde, Wolfgang E. and Stelljes, Matthias and Mayer, Jiri and Reichle, Albrecht and Baldus, Claudia D. and Schmitz, Norbert and Kramer, Michael and Roellig, Christoph and Bornhaeuser, Martin and Thiede, Christian and Ehninger, Gerhard (2016) Allogeneic Stem Cell Transplantation Improves Survival in Patients with Acute Myeloid Leukemia Characterized by a High Allelic Ratio of Mutant FLT3-ITD. BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 22 (3). pp. 462-469. ISSN 1083-8791, 1523-6536
Full text not available from this repository. (Request a copy)Abstract
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 (NPMI) in the Study Alliance Leukemia AML2003 trial. FLT3-ITD mutations were detected in 209 patients and concomitant NPMI mutations in 148 patients. Applying a predefined cutoff ratio of .8, AML was grouped into high- and low-ratio FLT3-ITD AML (HRFLT3-ITD and LRFLT3-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 HRFLT3-ITD AML who received alloHCT as consolidation treatment compared with patients who received consolidation chemotherapy. Patients with LRFLT3-ITD AML and wild-type NPMI 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 LRFLT3-ITD AML and concomitant NPMI mutation. In conclusion, our results provide additional evidence that alloHCT in first remission improves EFS and OS in patients with HRFLT3-ITD AML and in patients with LRFLT3-ITD AML and wild-type NPM1. (C) 2016 American Society for Blood and Marrow Transplantation.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | INTERNAL TANDEM DUPLICATION; HIGH-DOSE CYTARABINE; PROGNOSTIC-SIGNIFICANCE; FLT3/ITD-POSITIVE AML; NORMAL CYTOGENETICS; ADULT PATIENTS; 1ST REMISSION; 12 TRIALS; MUTATIONS; IMPACT; Allogeneic transplantation; Acute myeloid leukemia; FLT3-ITD; NPM1 mutation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Mar 2019 06:53 |
| Last Modified: | 12 Mar 2019 06:53 |
| URI: | https://pred.uni-regensburg.de/id/eprint/2345 |
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