Relapse risk and survival in patients with FLT3 mutated acute myeloid leukemia undergoing stem cell transplantation
Autor: | Partow Kebriaei, Jonathan E. Brammer, Sameh Gaballa, Rima M. Saliba, Michael Andreeff, Farhad Ravandi, Uday R. Popat, Jorge E. Cortes, Julianne Chen, Naval Daver, Stefan O. Ciurea, Gabriela Rondon, Amin M. Alousi, Keyur P. Patel, Elias Jabbour, David Marin, Richard E. Champlin, Betul Oran, Elizabeth J. Shpall, Borje S. Andersson |
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Rok vydání: | 2017 |
Předmět: |
Male
Oncology Neoplasm Residual Myeloid Polymerase Chain Reaction fluids and secretions 0302 clinical medicine Recurrence hemic and lymphatic diseases Remission Induction Hematopoietic Stem Cell Transplantation Myeloid leukemia hemic and immune systems Hematology Middle Aged Prognosis Survival Rate Leukemia Myeloid Acute Leukemia medicine.anatomical_structure 030220 oncology & carcinogenesis Preoperative Period embryonic structures Female Adult Risk medicine.medical_specialty Adolescent Article Young Adult 03 medical and health sciences Internal medicine medicine Humans Survival rate Survival analysis Aged Retrospective Studies business.industry Retrospective cohort study medicine.disease Survival Analysis Minimal residual disease Surgery Transplantation fms-Like Tyrosine Kinase 3 Mutation business Stem Cell Transplantation 030215 immunology |
Zdroj: | American Journal of Hematology. 92:331-337 |
ISSN: | 0361-8609 |
Popis: | In patients with AML with FMS-like tyrosine kinase 3 (FLT3) mutations, the significance of minimal residual disease (MRD) detected by PCR before allogeneic stem cell transplantation (SCT) on outcomes after transplant remains unclear. We identified 200 patients with FLT3-AML who underwent SCT at our institution. Disease status at transplant was: first or second complete remission (CR1/CR2, n=119), high-risk CR (third or subsequent CR, marrow hypoplasia, or incomplete count recovery) (CR-HR, n=31), and morphological evidence of active disease (AD, n=50). The median follow-up was 27 months, and the 2-year overall and progression-free survival were 43% and 41%, respectively. Relapse was highest in the AD group (85%) and the CR-HR FLT3 MRD positive group (72%), followed by CR-HR FLT3 MRD negative (58%), CR1/CR2 FLT3 MRD positive (39%), and lowest in the CR1/CR2 FLT3 MRD negative group (23%). On multivariate analysis, independent factors influencing the risk of relapse were detectable morphological disease and FLT3 MRD by PCR pre-transplant. Factors that did not influence the relapse risk included: age, graft type, graft source, type of FLT3 mutation, or conditioning intensity. Morphologic and molecular remission status at the time of transplant were key predictors of disease relapse and survival in patients with FLT3-AML. This article is protected by copyright. All rights reserved. |
Databáze: | OpenAIRE |
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