Dokumentenart: | Artikel | ||||
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Titel eines Journals oder einer Zeitschrift: | Biology of Blood and Marrow Transplantation | ||||
Verlag: | Elsevier | ||||
Ort der Veröffentlichung: | NEW YORK | ||||
Band: | 22 | ||||
Nummer des Zeitschriftenheftes oder des Kapitels: | 3 | ||||
Seitenbereich: | S. 462-469 | ||||
Datum: | 2016 | ||||
Institutionen: | Medizin > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) | ||||
Identifikationsnummer: |
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Stichwörter / 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 | ||||
Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
Status: | Veröffentlicht | ||||
Begutachtet: | Ja, diese Version wurde begutachtet | ||||
An der Universität Regensburg entstanden: | Ja | ||||
Dokumenten-ID: | 41865 |
Zusammenfassung
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 ...
Zusammenfassung
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.
Metadaten zuletzt geändert: 17 Mrz 2020 11:01