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
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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